Successful urgent transplantation of an adult kidney into a child with inferior vena cava thrombosis.
Poor venous drainage options following inferior vena cava (IVC) thrombosis have been considered to complicate or preclude renal transplantation of adult kidneys into pediatric patients. We describe urgent renal transplantation in a 5-year-old (15.3 kg) male with IVC thrombosis using an adult living donor. Preoperative magnetic resonance venography revealed a patent infrahepatic/suprarenal vena cava and portal system. In surgery, the right liver lobe was mobilized sufficiently to anastomose the graft renal vein to the native IVC at the confluence of the native left renal vein and proximal vena cava. Graft function has remained excellent with serum creatinine of 0.5 mg/dL at 36 months. IVC thrombosis need not preclude successful transplantation of adult-sized kidneys into children.
Stevens
R B
RB
Department of Surgery, Division of Transplantation, University of Nebraska Medical Center, Omaha, NE, USA. rbstevens@unmc.edu
Yannam
G R
GR
Hill
B C
BC
Rigley
T H
TH
Penn
D M
DM
Skorupa
J Y
JY
D002675:Child, Preschool; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D018810:Magnetic Resonance Angiography; D008297:Male; D009929:Organ Size; D011859:Radiography; D012082:Renal Veins / Q000601:surgery; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*; D020246:Venous Thrombosis / Q000601:surgery*