The Neonatal Intensive Care Unit (NICU) as a Source of Deceased Donor Kidneys for Transplantation: Initial Experience With 20 Cases.

Urologic complications after transplantation of 225 en bloc kidneys from small pediatric donors ≤20 kg: Incidence, management, and impact on graft survival

“…Instead, EBKs with complications displayed the same excellent long‐term graft outcome with minimal attrition as their counterparts without complications. We also observed the previously reported extremely favorable long‐term post‐EBK results, with low rates of late vascular complications such as graft artery stenosis, and a graft survival that meets or even exceeds long‐term outcomes observed with standard criteria grafts from adult deceased or older live donors …”

“…We also observed the previously reported extremely favorable long-term post-EBK results, with low rates of late vascular complications such as graft artery stenosis, and a graft survival that meets or even exceeds long-term outcomes observed with standard criteria grafts from adult deceased or older live donors. 4,5,19,31,32 Our observations have several important clinical and pro- (2) the contribution, if any, of cold ischemia time to our results (as preservation times were very long for nearly all grafts); and (3) the impact of the imported vs local origin of the grafts (as nearly all grafts had been imported). Additionally, we did not assess the implication of ureteral complications using a bladder patch in our patient population, as most of our grafts were recovered at different centers, and there was no way to direct the recovery surgeons to do so even if this had been desired.…”

“…These complications increase posttransplant morbidity and are associated with substantially increased costs . For EBKs, however, urologic complications have not been systematically studied, even though en bloc transplants from small donors already have intrinsically higher rates of nonurologic complications and graft losses at baseline (eg, from graft thrombosis, primary nonfunction) …”

“…17 For EBKs, however, urologic complications have not been systematically studied, even though en bloc transplants from small donors already have intrinsically higher rates of nonurologic complications and graft losses at baseline (eg, from graft thrombosis, primary nonfunction). [4][5][6][7][8]13,18 Also, in the No analysis specifically dedicated to urologic complications after EBK has been published to date. Wijetunga et al 5 reported no urologic complications after 30 EBKs from donors <20 kg.…”

“…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 vascular graft thrombosis and primary nonfunction—especially in grafts from very small donors ≤8 kg . Against the background of these intrinsically increased early posttransplant graft losses, urologic complications in EBK recipients have not been specifically studied to date.…”