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

J Korean Soc Transplant. 2015 Sep;29(3):170-174. Korean.
Published online September 30, 2015.  https://doi.org/10.4285/jkstn.2015.29.3.170
Copyright © 2015 The Korean Society for Transplantation
Adult Kidney Transplantation of Pediatric En bloc Kidneys Using a Partial Bladder Wall
Seung Hwan Song, M.D.,1 Juhan Lee, M.D.,1 Woong Kyu Han, M.D.,2 Yu Seun Kim, M.D.,1 and Kyu Ha Huh, M.D.1
1Department of Transplantation Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
2Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Kyu Ha Huh. Department of Transplantation Surgery, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: 82-2-2228-2100, Fax: 82-2-323-8289, Email: KHHUH@yuhs.ac
Received July 06, 2015; Revised July 07, 2015; Accepted July 07, 2015.

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, hyperfiltration 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.

Keywords: Kidney transplantation; En bloc kidneys; Pediatric donor

Figures


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.
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Fig. 2
(A, B) Implantation of en bloc kidneys with partial bladder segment.
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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.
Click for larger image

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