Pediatric kidney donors are underutilized due to high risk of postoperative thrombosis and other complications. To address these problems, we develop a novel en bloc kidney transplantation by using distal abdominal aorta as an outflow tract.

Briefly, 8 cases of en bloc kidneys from deceased infant donors younger than 5 months with low body weight (1.9-4.9 kg) were transplanted into 4 pediatrics and 4 adults. Donor's common iliac artery or external iliac artery was anastomosed to recipient's distal external iliac artery (cases 1-4) or inferior epigastric artery (cases 5-8) respectively as an outflow tract. Recipients received Basiliximab or antithymocyte globulin as induction therapy followed by Tacrolimus, Mycophenolate Mofetil, and prednisone but without prophylactic anticoagulation. Delayed graft function was observed in 1 patient but was reversed at 90 days post-transplant. Two patients had urine leakage, which was cured by conservative treatments. Two recipients developed lung infection that was eventually cleared. However, none of them showed vascular thrombosis post-transplant. Outflow tracts were not seen in all pediatric recipients(A), but were seen in all except one of the adult recipients by CTA scanning at 1-month post-transplant (B). One of adult recipient's outflow tracts was still maintained at 1-year post-transplant (C). Currently all patients are well with normal serum creatinine values at 1-1.5 years follow-up.

In conclusion, this novel en bloc kidney transplantation from “marginal” donors by using an outflow tract could effectively avert graft vascular thrombosis and provide adequate graft function.

CITATION INFORMATION: Dai H., Peng L., Peng F., Lan G., Wang Y., Chen J., Liu L., Gao C., Guo Y., Fang C., Nie M., Long W., Yu S. Using Distal Abdominal Aorta as an Outflow Tract for En Bloc Kidney Transplantation from Infant Donors with Extremely Low Body Weight Am J Transplant. 2017;17 (suppl 3).

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