En bloc kidney transplantation of an infant to an adolescent girl - one-year follow-up

Abstract

Introduction. En bloc kidney transplantation (EBKT) overcomes the problems of insufficient nephron mass of the solitary kidney of the youngest donors and the creation of a vascular anastomosis with small blood vessels. Although there are positive experiences with EBKT in adult patients, there is little data in pediatric recipients. Case outline. The kidney donor was a six-month-old male infant (7 kg), and the recipient was a 16-year-old adolescent girl (58.7 kg). The estimated glomerular filtration rate increased during the one-year follow-up after EBKT and reached 88.8 ml/min/1.73 m2, which was accompanied by an increase in the dimensions of the medial and lateral kidneys. Normalization of proteinuria and tubular functions occurred six and 12 months after transplantation, respectively. Conclusion. EBKT in an adolescent girl was performed without vascular complications, with satisfactory kidney function and physiological values of proteinuria after a one-year follow-up. EBKT of infants could increase the number of cadaveric donors but also enable better function and survival of the graft, given that the growth and functional maturation of the infant’s kidneys continue postnatally in the body of the graft recipient.

Keywords

• en bloc kidney transplantation
• small infant donor
• pediatric recipient
• postnatal kidney maturity