Journal List > J Korean Soc Transplant > v.29(3) > 1034464

Seung, Lee, Woong, Yu, and Kyu: Adult Kidney Transplantation of Pediatric En bloc Kidneys Using a Partial Bladder Wall

Abstract

Kidney transplantation is a treatment of choice which improves survival and quality of life for patients with end-stage renal disease. Due to the growing waiting list for kidney transplantation, expansion of the donor pool to use of deceased pediatric kidneys is of critical importance. However, the use of pediatric kidneys has been limited due to concerns about early graft failure, hyper-filtration injury, and technical difficulties. Performing ureteroneocystostomy using small pediatric en bloc kidneys is sometimes difficult due to the small diameter and short length of the ureter in the adult kidney recipient. We hereby report on a partial bladder wall transplantation using pediatric en bloc kidneys. Pediatric en bloc kidneys and partial bladder wall from a 12-month-old female donor who weighed 9.13 kg was transplanted into a 49-year-old male recipient. The urinary tract was reconstructed with a partial bladder wall of the donor. At 12 months post-transplantation, Doppler ultrasonograpy and renogram showed stable graft renal function without urological complications. Pediatric en bloc kidney transplantation with a partial bladder wall can be a safe and feasible surgical technique to reduce urological complications.

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Fig. 1.
(A) Pediatric en bloc kidneys with ureters and partial bladder segment. (B) Reconstruction of urinary tract with a partial bladder wall of the donor.
jkstn-29-170f1.tif
Fig. 2.
(A, B) Implantation of en bloc kidneys with partial bladder segment.
jkstn-29-170f2.tif
Fig. 3.
(A) Doppler ultrasonogram (U/S) image. Doppler U/S shows normal resistant index and vascularity. (B) Renogram image, renogram scan shows normal limits of blood flow and function.
jkstn-29-170f3.tif
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