Background: Transplantation (Tx) of PeB kidney grafts has been shown to result in good long-term outcomes. However, the fate of PeB grafts that suffer loss of one of their kidneys remains unknown.

Methods: Retrospective review was done of all PeB transplants (Txs) done at our center between 7/2003 & 10/2015.

Results: Of 240 PeB Txs, we identified 15 recipients that experienced Unilateral Loss (UL). Of these 15 ULs, 14 were due to thrombosis, 1 due to an intraop technical complication during Tx.

Donor (table1) & recipient (table 2) characteristics:

DGF rate was 53% for all grafts. 4 of 15 grafts with UL failed at 0 to 61 days post-Tx – 50% due to PNF & 50% due to thrombosis of the other kidney. 3 of the 4 failed grafts were from donors <5kg. Relaparotomy rate was 73%. Graft survival (Figure 1) for all 15 Txs, and post-Tx Cr levels for the 11 functioning grafts (Figure 2) were:

Conclusion: Despite increased surgical peri-Tx morbidity, UL in PeB grafts from donors >5kg resulted in good long term outcomes. Conversely, poorer outcomes of UL in PeB grafts <5kg, probably warrants early removal of the contralateral kidney. The excellent long-term outcomes of single grafts from small peds donors underscores the significant compensatory capacity of these PeB grafts & provides added rationale for pursuing PeB Tx from small peds donors into adult recipients.

CITATION INFORMATION: Santhanakrishnan C, Perez R, McVicar J, Sageshima J, Troppmannn C. Outcomes of Pediatric en Bloc Kidney (PeB) Grafts After Loss of a Single Kidney. Am J Transplant. 2016;16 (suppl 3).

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