Kidney transplantation confers a significant survival benefit to most patients with end-stage renal disease (as compared to remaining on dialysis). 1,2 Unfortunately, the demand for kidney grafts continues to far outstrip the number of available organs. 3 Owing to the severe donor shortage, there has been increased interest in considering grafts from small pediatric donors for transplantation-ie, donors that are so small that their kidneys warrant being transplanted en bloc in order to provide their recipients with a sufficient nephron mass. Early posttransplant outcomes and complications for pediatric en bloc kidney transplants (EBKs) remain, however, a clinical and regulatory challenge because of higher rates of early graft loss from

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