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En-Bloc Pediatric Kidney Transplant to Adult Recipient with Two Different Ureterovesical Anastomosis Techniques

Sang Hoon Kim, Hee Chul Yu, Hong Pil Hwang, Sik Lee

(Department of Surgery, Chonbuk National University Medical School and Hospital, Jeonju, Jeolla, South Korea)

Am J Case Rep 2019; 20:517-521

DOI: 10.12659/AJCR.914290

BACKGROUND: En-bloc kidney transplantation from a small pediatric donor to an adult recipient has become more common owing to the shortage of deceased donor kidneys. In pediatric en-bloc kidney transplantation, ureterovesical anastomosis can be done either via ureteroneocystostomy or via partial bladder wall transplantation. We report 2 cases of en bloc kidney transplantation from a pediatric deceased donor to an adult recipient using different ureterovesical anastomosis methods and the long-term outcomes.
CASE REPORT: Two pediatric en-bloc kidney transplantations to adult recipients were performed at our center. One case used a graft bladder segment from a 5-month-old male donor that was transplanted to a 45-year-old adult male recipient using the bladder patch technique and one case used 4-year-old male donor kidneys transplanted to a 54-year-old adult male recipient via ureteroneocystostomy with ureteroplasty for ureterovesical anastomosis. Both recipients have shown normal renal function and normal voiding, without urinary complications, such as vesico-ureteral reflux and ureter stricture, during the follow-up period.
CONCLUSIONS: These 2 case reports suggest that using small pediatric en-bloc kidneys would be a viable option to overcome the increasing shortage of donor kidneys for transplantation regardless of the method of ureterovesical anastomosis.

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