Back-Table Reduction of a Deceased Adult Donor Kidney for Transplantation Into a Small Child: A Six-Year Follow Up.
Kaabak Michael, Rappoport Nadeen, Gardashnik Rozanna et al.
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Case in brief
A 15-month-old boy with congenital nephrotic syndrome received a left kidney from a 46-year-old deceased donor. Due to size mismatch, the upper pole of the kidney was resected ex vivo, reducing its volume by one-third. The graft was implanted extraperitoneally, resulting in excellent immediate function and preserved renal architecture at six-year follow-up.
What made this case unusual
The case highlights the successful ex vivo reduction of a deceased donor kidney to accommodate a very small pediatric recipient, addressing significant donor-recipient size mismatch.
Diagnostic / clinical pearl
Clinicians should consider back-table reduction of donor kidneys as a viable option in pediatric transplantation to manage extreme size discrepancies.
Why it matters
This approach may expand the donor pool and improve outcomes for small pediatric patients requiring kidney transplants.