En Bloc Dual Kidney Transplantation from Pediatric Donors after Cardiac Death: Initial Experience in China

Objective: To report 9 cases of en bloc kidney transplantation from pediatric donors in China and share the clinical experience. Methods: From February 2010 to February 2014, 9 pediatric donors (aged 5 months to 6 years) were assigned to us by the modern donation and allocation system after cardiac death. The en bloc kidneys were recovered in all 9 patients. The inferior vena cava and aorta of the donors were anastomosed to the external vein and artery of the recipients (7 adults and 2 children). Alprostadil or enoxaparin sodium was used for anticoagulation. Results: The kidneys attained immediate perfusion after vascular anastomosis, except for one renal artery that developed thrombosis several minutes later, necessitating nephrectomy of the unilateral graft. The other eight en bloc grafts maintained normal function during the follow-up period of 1-50 months and all the patients survived. There were no rejections or other complications. Based on ultrasonography, the grafts increased in size during the follow-up period. Conclusions: These results indicate that en bloc renal transplantation from pediatric donors is an acceptable procedure, and more widespread use could increase the number of potential donors. Splitting of pediatric donor en bloc kidneys for transplantation into two recipients may also be feasible in well-matched cases. (C) 2014 S. Karger AG, Basel