En bloc kidney transplantation from infant donors younger than 10 months into pediatric recipients

Pediatr Transplant. 2017 Mar;21(2). doi: 10.1111/petr.12845. Epub 2017 Jan 1.

Abstract

Early graft loss and poor graft function limit the use of kidneys from infant donors. Six en bloc kidney transplantations were performed from infant donors younger than 10 months into pediatric recipients between November 2012 and September 2015 at our center. We retrospectively analyzed recipient and donor demographics, surgery procedures, complications, graft function and size, and patient and graft survival with a follow-up of 6-39 months (median 15.5 months). Donor age ranged from 1 to 10 months with weight ranging from 3.5 to 10 kg. Recipient age ranged from 10 to 16 years with weight ranging from 30 to 39 kg. One kidney was removed due to arterial thrombosis during surgery, while the other kidney of this en bloc graft remained viable. Urine leak followed by bilateral ureteral obstruction occurred in one recipient. All of the recipients showed immediate graft function. The size of the en bloc kidney increased from 4.2±0.6 cm to 7.6±0.6 cm 6 months after surgery. Patient and graft survival were both 100% at the last follow-up. Our results show that en bloc kidney transplantation from infant donors younger than 10 months into pediatric recipients is effective under the condition of experienced surgical techniques and perioperative management.

Keywords: en bloc kidney transplantation; infant donors; outcome; pediatric; surgical procedures.

MeSH terms

  • Adolescent
  • Arteries / physiopathology
  • Body Weight
  • Child
  • Female
  • Glomerular Filtration Rate
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Infant, Newborn
  • Kidney Transplantation / methods*
  • Male
  • Renal Insufficiency / surgery*
  • Retrospective Studies
  • Thrombosis / etiology
  • Tissue Donors*
  • Treatment Outcome
  • Ureteral Obstruction / etiology

Substances

  • Immunosuppressive Agents