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Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant I: Introduction01:28

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Single Port Donor Nephrectomy
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Simultaneous Native Right Nephrectomy and Extraperitoneal Pediatric Kidney Transplantation Using the Same Incision

Gaetano Ciancio1, Marina M Tabbara2, Jeffrey J Gaynor2

  • 1Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, Florida; Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, Florida; Department of Urology, University of Miami Miller School of Medicine, Miami, Florida.

Transplantation Proceedings
|September 20, 2025
PubMed
Summary
This summary is machine-generated.

Simultaneous extraperitoneal kidney transplant and native nephrectomy in pediatric patients is safe and effective. This single-incision approach avoids multiple procedures and incisions, improving outcomes for children with end-stage kidney disease.

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Area of Science:

  • Pediatric Surgery
  • Nephrology
  • Transplantation Surgery

Background:

  • Kidney transplantation is optimal for pediatric end-stage kidney disease but faces challenges with donor-recipient size mismatch.
  • The extraperitoneal approach is preferred over the intraperitoneal route due to lower morbidity.
  • Native kidney nephrectomy is often required with the extraperitoneal approach to optimize graft placement.

Purpose of the Study:

  • To assess clinical outcomes of simultaneous native right nephrectomy and extraperitoneal kidney transplantation in pediatric recipients.
  • To evaluate the safety and feasibility of a single-incision approach for these combined procedures.
  • To determine if this approach avoids the need for staged procedures or multiple incisions.

Main Methods:

  • Retrospective review of pediatric patients (age ≤18 years) undergoing simultaneous right native nephrectomy and open extraperitoneal kidney transplant.
  • Study period: 2017-2023 at a single center.
  • Analysis of perioperative data, graft function, and complications.

Main Results:

  • Seven pediatric patients (median age 4 years, all male) underwent the combined procedure.
  • Median recipient weight was 16.5kg; donors included both deceased and living related individuals.
  • No cases of delayed graft function, vascular, or urological complications were reported; excellent graft function was observed post-transplant.

Conclusions:

  • Simultaneous extraperitoneal kidney transplantation with native nephrectomy via a single incision is safe and feasible in pediatric patients.
  • This approach effectively manages donor-recipient size mismatch and avoids staged procedures.
  • The technique offers a simplified surgical strategy with favorable early outcomes.