ESPN 50th Annual Meeting

ESPN 2017


 
Our experience in en-bloc kidney transplantation including partial bladder patch technic patients, into children recipients.
CANER ALPARSLAN 1 EREN SOYALTIN 1 FATMA MUTLUBAŞ 1 SEÇIL ARSLANSOYU ÇAMLAR 1 ELIF PERIHAN ÖNCEL 2 DEMET ALAYGUT 1 BELDE KASAP DEMIR 3 ÖNDER YAVAŞCAN 1 CEM TUĞMEN 4 EYÜP KEBABÇI 4 CEZMI KARACA 4

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL, PEDIATRIC NEPHROLOGY
2- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL, PEDIATRICS
3- IZMIR KATIP CELEBI UNIVERSITY, PEDIATRIC NEPHROLOGY
4- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL, ORGAN TRANSPLANTATION UNIT
 
Introduction:

The concept of en-bloc kidney transplantation was born due to high discard rate of young donor patients kidneys (5-year-old,<15 kg in weight, 6 cm in kidney diameters).Despite improved outcomes are reported in pediatric kidney transplantation, literature is still limited about en-bloc kidney transplantation with/without partial bladder segment.

Material and methods:

This retrospective study was conducted in 4 children who underwent en-bloc kidney transplantation with/without partial bladder segment between 2005-2016. Baseline donor, patient and transplant features and also, protocol biopsy results were collected.

Results:

There are totally 71 pediatric kidney transplantation was performed (en-bloc kidney transplantation in 4 patients (5.6%)). The mean donor age and weight are 8 months and 9.5kg, respectively. Recipient number 4 is in the 3rd month of follow-up. The mean age at the transplantation and body weight were 8 years and 20.9kg,respectively. En-bloc kidney transplantation was applied with partial bladder segment in two. There was only one renal artery thrombosis due to organ displacement required unilateral donor nephrectomy (recipient 4). Five years of follow-up serum creatinine, eGFR and urinary protein excretion of 3 patients were in normal range. There were no biopsy proven rejection or chronic allograft nephropathy detected in protocol biopsies. Also, growth of these graft pairs were detected in routine ultrasonographic imaging.

Conclusions:

In the setting of inadequate donor pool, for maximize of organ usage en-bloc kidney transplantation seems suitable approachement. The outcomes of en-bloc kidney transplantation in adults are same as an ideal kidney transplantation. To delinate effectiveness of en-bloc kidney transplantation into children further studies are needed.