소아 뇌사자 신장을 이용한 성인 수여자로의 신장이식

Abstract

The imbalance between supply and demand of transplantable organ has created pressure within the transplant community to scrutinize all potential donor organs for optimal use. In the 1970s, heavy skepticism surrounded the use of pediatric kidneys for transplantation. Today, although skepticism has evolved into acceptance, the optimal use of the of very young donor kidneys remains unclear. But the use of cadaver kidney from newborns through adolescence will certainly increase the pool of available cadaver kidneys: therefore, at present time it would seem reasonable not to preemptively exclude any potential pediatric cadaver donor regardless of age with the understanding that graft from pediatric cadaveric donors may yield suboptimal results. The purpose of this paper reviews the basic physiologic changes in pediatric cadaver kidney transplants and provides for selective, and surgical strategies to minimize morbidity associated with these organs and maximize graft survival.