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How small is too small and how young is too young when allocating pediatric deceased donor kidneys to optimize kidney transplant rates?

I this issue of the journal, Suneja et al present a very informative analysis of the usage of small (donor age <8 y and weight <30 kg) pediatric deceased donor kidneys and associated outcomes in the United States. Not surprisingly given the relative scarcity of pediatric donors (and recipients), some of their findings and conclusions are not entirely firm from a statistical perspective. That being said, several important threads emerge from this article: