En bloc kidney transplant from an 18-month-old donor to an adult recipient: Case report and literature review.
BACKGROUND
There is an ever-increasing need for organ donations globally. Paediatric kidney transplantation into adult recipients is a well-recognised technique to expand the donor pool. The transplantation can be done either via en bloc kidney transplant (EBKT) or as single kidney transplantation (SKT).


METHODS
An EKBT from a 18-month-old (15kg) male patient was transplanted in a 35-year old, 85kg male with end stage renal failure (ESRF), secondary to Focal Segmental Glomerulosclerosis (FSGS) on haemodialysis. Post-operative recovery was uneventful. Immuno-suppressant drugs used were tacrolimus, basiliximab and prednisolone. Doppler ultrasound scans performed post-operatively showed normal renal resistive indices in both kidneys. Serum creatinine decreased from 1200 to 170μmol/L 57 with eGFR improving from 4 to 38mL/min/1.73m(2) at four weeks post-transplant.


CONCLUSIONS
Given the low incidence of paediatric donors, EBKTs are relatively uncommon and subsequently published series tend to be centre specific with small numbers. The graft survival rates tell us that paediatric kidney donors should not be considered as marginal transplants. The difficulty is in determining when it is more appropriate to perform a paediatric EBKT as opposed to splitting and performing two SKT. Unfortunately there are no widely accepted guidelines to direct clinicians.


CONCLUSIONS
This case report highlights the first EKBT performed at our institution. The current literature demonstrates that paediatric donors are excellent resources that should be procured whenever available.
University of Western Australia, School of Surgery, Crawley WA 6009, Australia; Department of Vascular Surgery, Royal Perth Hospital, Level 2, MRF Building, Perth, WA 6001, Australia. Electronic address: bibombe@iinet.net.au.
B Patrice
BP
Mwipatayi
Chee Weng
CW
Leong
Pradeep
P
Subramanian
Alarick
A
Picardo
En bloc kidney transplant; Paediatric kidney donor; Single kidney transplantation