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The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation
Author(s) -
Giuliani Stefano,
Gamba Pier Giorgio,
Chokshi Nikunj Kanu,
Gasparella Paolo,
Murer Luisa,
Za Giovanni Franco
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01034.x
Subject(s) - medicine , body surface area , transplantation , kidney transplantation , renal function , urology , dosing , kidney , risk factor , gastroenterology , surgery
In pediatric kidney transplantation, the effect of inadequate nephron dosing on graft survival remains undetermined. The aim of this study was to assess the use of D/R BSA, as a reliable indicator of adequate nephron dosing, and eventually a tool to optimize pediatric graft allocation. Following Institutional Review Board approval, we reviewed deceased donor pediatric kidney transplantation (N = 156). We divided patients into three groups, based on D/R BSA: A ≤0.8; B 0.81–1.19; C ≥1.2. Five‐yr graft survival rates in the groups were: A 82.0%; B 94.9%; C 97.1% (p = 0.01). Group C had the lowest rate of acute rejection, suggesting a protective effect of increased D/R BSA (group A = 35.7%, group B = 38.9%, group C = 18.8%; p = 0.029). The logistic regression analysis showed that decreased D/R BSA ratio is a risk factor for loss of graft function, at one and five yr [i.e., group A OR 6 (95% CI 1.14–39.30, p = 0.015) and OR 4.49 (95% CI 1.46–13.79, p = 0.009), respectively]. We conclude that for pediatric recipients, D/R BSA is a valuable adjunct when determining long‐term graft survival. Its utility may avoid an alloimmune‐independent risk factor, increasing the long‐term protective value of a good matching policy.