Kidney Transplantation From a 5-Day-Old Donor With a Single Functioning Kidney

Area of Science:

• Nephrology
• Transplantation immunology
• Pediatric surgery

Background:

• End-stage renal failure necessitates renal replacement therapy, with kidney transplantation being a primary treatment.
• A critical shortage of donor kidneys exists, driving the need to expand the donor pool.
• Neonatal organ donation (less than 28 days old) is an underutilized resource for increasing kidney availability.

Observation:

• A case report details an en bloc kidney transplant from a 5-day-old donor after circulatory death into an adult recipient.
• Immediate thrombosis of one kidney resulted in a single, poorly functioning 4.5-cm neonatal kidney remaining for the recipient.
• The recipient's renal function was monitored post-transplant.

Findings:

• The single neonatal kidney demonstrated compensatory growth and adaptation over 18 months.
• The recipient exhibited improving estimated glomerular filtration rate (eGFR), indicating successful renal function restoration.
• This case highlights the potential of a single neonatal kidney to sustain adult renal function.

Implications:

• Single neonatal kidneys can provide adequate long-term renal function in adult recipients.
• Maximizing the utilization of neonatal kidneys is crucial for addressing the donor organ shortage.
• This approach offers a promising strategy to improve outcomes for patients with end-stage renal failure.