En bloc kidney transplantation: case report
Abstract
In Mexico, chronic kidney disease is a major public health problem in pediatric patients. The therapeutic options for chronic kidney disease (CKD) in children are dialysis and kidney transplant (KT); the latter constitutes the current treatment of choice for children suffering from end-stage renal disease. The aim of this study was to describe our experience of perioperative treatment of pediatric patients undergoing en bloc kidney transplant.Female patient, 12 years old, from Veracruz, Mexico, suffering from stage 4 CKD according to KDOQI criteria, secondary to glomerulonephritis. An en bloc kidney transplantarion from a pediatric deceased donor was performed; balanced general anesthesia with mechanical ventilation was used. Cold ischemia time was 17 hours and warm ischemia time was 30 minutes. The surgery lasted 5 hours and 10 minutes and the total anesthesia time was 6 hours. The patient was taken to the pediatric intensive care unit and showed an adequate renal graft acceptance. During the following seven months the clinical course was satisfactory and kidney echotomography showed normal results.
Glomerulonephritis made this patient undergo hemodialysis replacement therapy due to CKD at a very early age. The en bloc kidney transplantation performed was successful thanks to the multidisciplinary management involved in the Kidney Transplant Program.
References
Mwipatayi BP, Leong CW, Subramanian P, Picardo A. En bloc kidney transplant from an 18-month-old donor to an adult recipient: Case report and literature review. Int J Surg Case Rep. 2013;4(11):948-51.
Zhao WY, Zhang L, Zhu YH, Chen Y, Zhu FY, Shen Q, et al. En bloc kidneys transplanted from infant donors less than 5 kg into pediatric recipients. Transplantation. 2014;97(5):555-8.
Medeiros Domingo M, Muñoz Arizpe R. Enfermedad renal en niños. Un problema de salud pública. Bol Med Hosp Infant Mex. 2011;68(4):239-41.
Whittaker VE, Gruessner RW. En Bloc Kidney Transplants from Pediatric Donors into Children-An Underutilized Transplant Option? J Pediatr. 2016;173:9-10.
Winnicki E, Dharmar M, Tancredi D, Butani L. Comparable Survival of En Bloc versus Standard Donor Kidney Transplants in Children. J Pediatr. 2016;173:169-74.
Fananapazir G, Tse G, Corwin MT, Santhanakrishnan C, Perez RV, McGahan JP, et al. Pediatric En Bloc Kidney Transplants: Clinical and Immediate Postoperative US Factors Associated with Vascular Thrombosis. Radiology. 2016;279(3):935-42.
Li Y1, Li J, Fu Q, Deng R, Liu L, Yuan X, et al. En bloc dual kidney transplantation from pediatric donors after cardiac death: initial experience in China. Urol Int. 2014;93(4):482-6.
Dion M, Rowe N, Shum J, Weernink C, Felbel S, McAlister VC, et al. Donation after cardiac death pediatric en bloc renal transplantation. J Urol. 2015;193(1):281-5.
Peng F, Yu S, Peng L, Xie X, Gao C, Tan L, et al. Transplantation of en bloc kidneys from cardiac deceased small pediatric donors: 2 case reports and literature review. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014;39(2):204-8.
Raza SS, Ravula PK, Hakeem AR, Lodge PA, Baker RJ, Ahmad N. En bloc kidney transplant from young pediatric donors: a scope to increase the donor pool. Exp Clin Transplant. 2014;12(3):261-4.
Milladipour AH, Rezaei Hemami M. Renal Function Assessment in Adults with Recurrent Calcium Kidney Stone Disease. J Nephrol Ther. 2012;2(4):121.
Thomusch O, Tittelbach-Helmrich D, Meyer S, Drognitz O, Pisarski P. Twenty-year graft survival and graft function analysis by a matched pair study between pediatric en bloc kidney and deceased adult donors grafts. Transplantation. 2009;88(7):920-5.
