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Successful En-Bloc Kidney Transplantation from a 5-Month-Old Donor to a 63-Year Old Recipient: A Case Report

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Author(s)
Kang Seong SikPark, Ha YeonYeo, Sang MokPark, Woo YeongHan, SeungyeupPark, Sung BaePark, Ui JunKim, Hyoung TaeYoon, JeongsooJin, Kyubok
Keimyung Author(s)
Kang, Seong SikPark, Woo YoungHan, Seung YeupPark, Sung BaePark, Ui JunKim, Hyoung TaeJin, Kyu Bok
Department
Kidney Institute (신장연구소)
Dept. of Internal Medicine (내과학)
Dept. of Surgery (외과학)
Journal Title
Transplantation
Issued Date
2017
Volume
101
Abstract
Introduction :

Pediatric deceased donor kidney transplantation (DDKT) has been increasing gradually as a donor pool expansion method. In addition, the outcomes of pediatric DDKT over the last 20 years have shown excellent results with an active practice of en-bloc KT (EBKT) which increases kidney volume. We report pediatric en-bloc KT performed with organ donation from the youngest 5-month-old infant in our institution.

Presentation of Case :

En-block kidney of a 5-month-old female infant with a body weight of 3.2 kg diagnosed with brain death due to hypoxic injury was transplanted into a 63-year old female patient with a body weight of 56 kg, who was receiving continuous ambulatory peritoneal dialysis (CAPD) for IgA nephropathy end-stage renal disease. The human leukocyte antigen mismatches were 3 and both panel reactive antibody and donor-specific antibody were negative. Basiliximab was used as the induction immunosuppressant.

Results :

Cold ischemia times were 187 minutes. Both kidneys weighed 56 g and distal ends of the donor aorta and vena cava were anastomosed to internal iliac artery and external iliac vein of the recipient. Tacrolimus, mycophenolate mofetil, and prednisolone were used as the maintenance immunosuppressant. Postoperative renal doppler sonography showed mild hydronephrosis in one kidney and small amount perinephric free fluid collection, but both improved in follow-up examination. On the 20th day of KT, the serum creatinine level decreased to 1.23 mg/dL with estimated glomerular filtration (eGFR) 44.1 mL/min/1.73 m2 and CAPD catheter was removed. At 5 months after KT, serum creatinine was 0.90 mg/dL and eGFR was 63.0 mL/min/1.73 m2.

Conclusion :

This case report highlights the successful KT to an adult with en-bloc kidney of a 5-month-old infant. And long-term follow-up on whether small kidneys of 56 g adapt appropriately and function well in adult is needed.
Keimyung Author(s)(Kor)
강성식
박우영
한승엽
박성배
박의준
김형태
진규복
Publisher
School of Medicine (의과대학)
Citation
Kang Seong Sik et al. (2017). Successful En-Bloc Kidney Transplantation from a 5-Month-Old Donor to a 63-Year Old Recipient: A Case Report. Transplantation, 101, S127–S127. doi: 10.1097/01.tp.0000525178.28641.ab
Type
Article
ISSN
0041-1337
Source
https://insights.ovid.com/crossref?an=00007890-201708002-00214
DOI
10.1097/01.tp.0000525178.28641.ab
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41488
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
3. Research Institutues (연구소) > Kidney Institute (신장연구소)
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