Multivisceral transplantation using a 2.9 kg neonatal donor

Area of Science:

• Pediatric Surgery
• Organ Transplantation
• Neonatology

Background:

• Neonatal organ donation is often contraindicated due to prematurity and very low birthweight.
• Unclear brain death guidelines complicate organ procurement from neonatal donors.

Observation:

• A successful multivisceral transplant was performed using a graft from a 10-day-old, 2.9 kg neonatal donor.
• The recipient was a 3-month-old infant with intestinal and liver failure.

Findings:

• The patient showed immediate liver graft function and corrected coagulopathy.
• Long-term follow-up revealed normal intestinal and liver function with the last rejection episode 30 months prior.
• Graft survival and function were achieved despite donor size and recipient condition.

Implications:

• Multivisceral grafts from small or young neonatal donors can be successfully transplanted in select cases.
• Revisiting brain death guidelines for premature and young infants may increase organ availability for infant recipients.
• This case highlights the potential to overcome perceived contraindications in neonatal organ donation.