Abstract: PUB502
Single-Center Experience of En Bloc vs. Single Kidney Transplantation: A Case Series
Session Information
Category: Transplantation
- 2102 Transplantation: Clinical
Author
- Chang, Yoon-Jung, The University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, United States
Introduction
Pediatric en bloc kidney recipients have been shown to demonstrate comparable outcomes with reduced potential risk for complications despite the reduced size and mass. This case series is focused on comparing the post-operative outcomes between recipients of en bloc kidneys from deceased donors and recipients of single kidneys from living or deceased donors.
Case Description
This case series includes a total of 61 patients - 12 pediatric en bloc recipients, 5 adult en bloc (horseshoe) recipients, and 11 per single kidney recipient groups. Living and deceased donor single kidneys had EPTS values ranging from 67 to 83 and a KDPI value of less than 50, whereas the EPTS and KDPI values of en bloc kidneys varied to a greater degree. The most prevalent primary renal disease among en bloc and single kidney recipients were hypertensive nephrosclerosis and diabetes mellitus type II, respectively. Not only did we see an increase in eGFR values and a decrease in serum creatinine values in the pediatric donors’ recipients, but the rate of delayed graft function was also lower in pediatric en bloc kidney recipients (16.67%) compared to that of single kidney recipients from living (18.18%) or deceased donors (54.55%).
Discussion
The results from this institution, along with the literature published, support the notion that en bloc renal transplantations from pediatric donors result in superior outcomes. Though receiving organs from pediatric donors has been previously neglected due to technical complications, the continuous advancement in surgical techniques and increased demand for transplantations have allowed for further exploration in en bloc renal transplantations. As evidenced by the data, it may be crucial to take into account the positive outlook on long-term renal functions of the pediatric en bloc kidneys to decrease the wait time and increase the quality of life of the patients.
Figure 1. (left) Serum creatinine levels of en bloc vs. single kidney transplantation adult recipients post-transplant, 1-week, 1-month, 3-months, and 1-year post-op. (right) eGFR levels of en bloc vs. single kidney transplantation adult recipients post-transplant, 1-week, 1-month, 3-months, and 1-year post-op.