Javier Gonzalez1, Akin Tekin2, Paolo Vincenzi2, Angel Alvarez3, Gaetano Ciancio4. 1. Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 2. Department 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. 3. Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, Florida. 4. Department 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, Jackson Memorial Hospital, Miami, Florida. Electronic address: gciancio@med.miami.edu.
Abstract
BACKGROUND: En bloc pediatric kidney (EBPK) allografts represent one potential solution to increase the number of organs available in the donor pool, thus facilitating transplantation of kidneys from young donors into adult recipients. However, EBPK transplantation has been traditionally considered suboptimal because of concerns for perioperative complications. METHODS: An extensive reconstruction and successful transplantation of an EBPK allograft using same pediatric donor vascular grafts and a bladder patch aiming to avoid postoperative complications is presented in this report. RESULTS: The warm ischemia time was 25 minutes. No surgical drainage or ureteral stent were used. Postoperative Doppler ultrasound showed laminar blood flow and normal parameters in both the external iliac and graft arteries, no collections, and no signs of obstructive uropathy. The patient had an uneventful recovery showing a creatinine level of 0.86 mg/dL and 0.85 mg/dL at 1 month and 3 months, respectively. CONCLUSIONS: A refined back-table reconstruction of these allografts is crucial to avoid mishaps in the postoperative period.
BACKGROUND: En bloc pediatric kidney (EBPK) allografts represent one potential solution to increase the number of organs available in the donor pool, thus facilitating transplantation of kidneys from young donors into adult recipients. However, EBPK transplantation has been traditionally considered suboptimal because of concerns for perioperative complications. METHODS: An extensive reconstruction and successful transplantation of an EBPK allograft using same pediatric donor vascular grafts and a bladder patch aiming to avoid postoperative complications is presented in this report. RESULTS: The warm ischemia time was 25 minutes. No surgical drainage or ureteral stent were used. Postoperative Doppler ultrasound showed laminar blood flow and normal parameters in both the external iliac and graft arteries, no collections, and no signs of obstructive uropathy. The patient had an uneventful recovery showing a creatinine level of 0.86 mg/dL and 0.85 mg/dL at 1 month and 3 months, respectively. CONCLUSIONS: A refined back-table reconstruction of these allografts is crucial to avoid mishaps in the postoperative period.
Authors: Juliano Riella; Marina M Tabbara; Phillipe Abreu; Javier Gonzalez; Gaetano Ciancio; José Maria Figueiro Journal: Case Rep Transplant Date: 2022-06-16