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Ten-year experience with infant kidneys transplanted en bloc
D D Nghiem1, J D Schlosser, H G Nghiem
1Allegheny University of the Health Sciences, Department of Surgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
Summary
En bloc infant kidney transplants into adults show excellent long-term function and survival. This study suggests increased use of infant kidneys for transplantation can be beneficial.
Area of Science:
- Nephrology
- Transplantation Surgery
- Pediatric Surgery
Background:
- Infant kidneys are rarely used for adult transplantation due to size and presumed functional limitations.
- En bloc transplantation of infant kidneys offers a potential solution to donor organ shortages.
Purpose of the Study:
- To evaluate the long-term outcomes and graft function of en bloc infant kidneys transplanted into adult recipients.
- To assess the feasibility and success rate of this innovative transplantation approach.
Main Methods:
- Retrospective analysis of 78 en bloc infant kidney transplants performed between 1987 and 1997.
- Detailed review of donor and recipient demographics, surgical techniques, immunosuppression protocols, and patient follow-up data.
- Assessment of graft survival, renal function (serum creatinine, creatinine clearance), and complications.
Main Results:
- Graft survival at 42 months was 79%.
- Excellent long-term renal function was observed, with mean serum creatinine levels of 0.8 mg/dL at 9 years and normal proteinuria.
- Complications included graft thrombosis (5), ureteral fistula (2), and renal artery stenosis (7), all managed successfully. Hyperfiltration injury was not observed.
Conclusions:
- En bloc transplantation of infant kidneys into adult recipients is a successful procedure with excellent long-term graft survival and function.
- The absence of observed hyperfiltration injury supports the use of infant kidneys.
- Increased utilization of infant kidneys for transplantation is recommended to address organ scarcity.