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Pediatr Transplant. 2019 Aug;23(5):e13452. doi: 10.1111/petr.13452. Epub 2019 May 8.

Non-standard criteria donors in pediatric kidney transplantation.

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Pediatric Nephrology Division, Pediatric Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.


KT remains the treatment of choice for ESRD in children. However, the demand for kidney transplants continues to outstrip supply, even in the pediatric scenario. We reviewed the applicability of nonSCDs for pediatric KT. There is a lack of studies analyzing this modality among pediatric donors and recipients, where most conclusions are based on predictions from adult data. Nevertheless, marginal donors might be a reasonable option in selected cases. For example, the use of older LDs is an acceptable option, with outcomes comparable to SCDs. Organs donated after cardiac death represent another possibility, albeit with logistic, ethical, and legal limitations in some countries. AKI donors also constitute an option in special situations, although there are no pediatric data on these transplants. Likewise, there are no data on the use of expanded criteria donors in pediatric patients, but this appears not to be a good option, considering the compromised long-term survival.


children; donor selection; kidney transplantation; prognosis; tissue and organ procurement


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