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  • Title: En bloc paediatric kidney transplant: is this the best use of a scarce resource?
    Author: Lam VW, Laurence JM, Robertson P, Hawthorne W, Ryan BJ, Lau HM, Allen RD, Pleass HC.
    Journal: ANZ J Surg; 2009; 79(1-2):27-32. PubMed ID: 19183375.
    Abstract:
    BACKGROUND: Kidney transplants using organs from paediatric cadaver donors are uncommon and technically difficult. It has become accepted practice to transplant both kidneys en bloc from donors of 5 years into a single recipient. We aim to compare outcomes of en bloc kidney (EBK) transplants versus single kidney (SK) transplants from cadaver donors of age 5 years and lesser. METHODS: Data reported to Australia and New Zealand Dialysis and Transplant Registry from 1989 to 2004 were analysed. RESULTS: From donors 5 years of age and younger, there were 33 EBK and 38 SK transplants carried out. Overall graft survival rates at 1 and 5 years were 78 and 61%, respectively, in the EBK group and 63 and 55%, respectively, in the SK group (P = 0.94). Vascular thrombosis was the most common cause of early graft loss with an incidence of 11 and 18%, respectively, in the EBK and SK groups (P = 0.5). CONCLUSION: There is a trend towards a lower vascular thrombosis rate and a better long-term graft survival in EBK transplants. These transplants will remain a technical challenge for the surgeon and EBK transplants should remain the technique of choice for donors of 5 years and lesser.
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