En Bloc Kidney Transplantation: A Retrospective Study of an 18-year Experience in a Single Institution

Mazancourt, E. Seizilles de; Badet, Lionel; Duarte, Ricardo Codas; Morélon, Emmanuel; Crouzet, Sébastien; Terrier, N.; Matillon, X.

doi:10.1016/j.euros.2022.10.012

Cited by 2 publications

(4 citation statements)

References 28 publications

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“…Moreover, the graft continues to significantly grow until last follow‐up with mean length of 8.24 ± 1.12 cm. These findings are consistent with many published papers 11–14 . There was one patient who developed DGF and one patient who developed a ureteric stricture which did not affect long‐term graft survival.…”

Section: Discussionsupporting

confidence: 92%

“…These findings are consistent with many published papers. [11][12][13][14] There was one patient who developed DGF and one patient who developed a ureteric stricture which did not affect long-term graft survival.…”

Section: Discussionmentioning

confidence: 97%

“…Multiple recent publications reported comparable graft survival outcomes between en bloc pediatric kidney donors and standardliving and deceased adult donor transplant. 14,[16][17][18][19] Furthermore, several pediatric studies conducted in the past few years have demonstrated the long-term advantages of utilizing en bloc kidneys, despite the higher immediate perioperative risk associated with vascular complications and primary non-function. 18,20,21 Furthermore, study conducted by Winnicki et al demonstrated that pediatric kidney recipients who underwent en bloc transplantation exhibited a significantly higher eGFR after a 4-year period, comparison to children who received standard kidney transplants.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple recent publications reported comparable graft survival outcomes between en bloc pediatric kidney donors and standard‐living and deceased adult donor transplant 14,16–19 . Furthermore, several pediatric studies conducted in the past few years have demonstrated the long‐term advantages of utilizing en bloc kidneys, despite the higher immediate perioperative risk associated with vascular complications and primary non‐function 18,20,21 …”

Section: Discussionmentioning

confidence: 99%

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Pediatric en bloc kidney transplant from donors <15 kg: An excellent approach to expand the pediatric deceased donor pool

Azzam,

Tawfeeq,

Obeid

et al. 2024

Pediatric Transplantation

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IntroductionMost kidneys from small pediatric donors are transplanted to adult recipients because of the perceived risk of surgical complications and graft thrombosis. In this study, we aim to demonstrate our favorable outcomes in transplanting pediatric kidneys from donors <15 k into pediatric recipients.MethodsThis study retrospectively analyzes the outcomes of seven pediatric recipients of en block kidney transplants from pediatric donors weighing <15 kg performed at King Fahad Specialist Hospital‐Dammam from December 2014 to January 2018.Baseline characteristics of donors and recipients were collected. The incidences of surgical complication, immediate, and intermediate graft function were the primary outcomes.ResultsThe study included seven recipients monitored for a mean duration of 6.86 ± 1.35. Donors’ and recipients’ mean weights were 7.4 ± 3.2 kg and 20.7 ± 9.2 kg, respectively. Ureteric stricture occurred in one patient. There was a substantial improvement of 1‐year estimated glomerular filtration rate (eGFR) compared to the 1‐week mark (106.7 ± 26.38 mL/min. 1.73 m2 vs. 63.7 ± 22.92 mL/min/1.73 m2, p = .0069). The observed improvement in renal function persisted at the 5‐year mark and during the last follow‐up, with eGFR of 70.3 ± 40.7 mL/min/1.73 m2, and 79.8 ± 30.8 mL/min/1.73 m2, respectively. There was also increase of 27.9% in the size of the en bloc kidney observed at the 6 months.ConclusionIn a specialized transplant center with highly skilled surgeons, the utilization of en bloc kidney transplant from donors weighing less than 15 kg is an effective strategy for expanding the donor pool and ensuring favorable graft outcomes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pediatric en bloc kidney transplant from donors <15 kg: An excellent approach to expand the pediatric deceased donor pool

Azzam,

Tawfeeq,

Obeid

et al. 2024

Pediatric Transplantation

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Surgical Strategies for Renal Transplantation: A Pictorial Essay

Novacescu,

Latcu,

Raica

et al. 2024

JCM

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This pictorial essay aims to navigate through the complexities and challenges of renal transplantation (RT), by weaving together visual imagery with clinical insights within a comprehensive illustrative surgical guide. Herein, we provide a detailed visual exploration of the intricate anatomy and surgical processes necessary for both renal graft retrieval from the donor and also for an adequate implantation in the recipient. Regarding graft retrieval, after reviewing the relevant retroperitoneal surgical anatomy, and donor nephrectomy techniques, graft preservation and optimal backbench graft dissection principles were meticulously analyzed. Thereafter, the recipient surgical strategy for graft implantation was addressed, focusing on preoperative preparations, the site of implantation selection, exposure, operative bed dissection, graft revascularization, and urinary tract reconstruction. Careful donor and recipient selection, meticulous surgical execution, and rigorous postoperative management clearly hold a pivotal role in optimizing patient outcomes. Fostering a deeper understanding of the surgical nuances and clinical management practices that contribute to successful results post-RT, we hope to provide a useful practical tool for clinicians about to embark on the treacherous road of RT surgery. Innovative technologies and surgical practices that have already significantly improved the safety and effectiveness of RT stand testament to the importance of further scientific inquiry, conceptual developments, and clinical integration. Moving forward, it is essential that the medical community continues to refine these strategies and advocate for equitable access to transplantation, ensuring that advancements in the field translate into real-world benefits for all patients grappling with ESRD. The collaborative efforts of multidisciplinary teams are essential in addressing the complex clinical challenges associated with RT, with the ultimate goal of improving patient survival, enhancing graft longevity, and reducing healthcare disparities.

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En Bloc Kidney Transplantation: A Retrospective Study of an 18-year Experience in a Single Institution

Cited by 2 publications

References 28 publications

Pediatric en bloc kidney transplant from donors <15 kg: An excellent approach to expand the pediatric deceased donor pool

Pediatric en bloc kidney transplant from donors <15 kg: An excellent approach to expand the pediatric deceased donor pool

Surgical Strategies for Renal Transplantation: A Pictorial Essay

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