Mendoza-Sánchez F, García-de Otero G, Sánchez-Vergara S, Zepeda-González A, Angulo-López E, Pelayo-Orozco LÁ, González-Espinoza E

Language: Spanish
References: 30
Page: 38-42
PDF size: 87.36 Kb.

ABSTRACT

Introduction: In block kidney transplants from small pediatric donors are made with low frequency and even more if they are transplanted into very old recipients. In Mexico there are no reports of kidney transplants of this type, so here we present the first case to publish. Clinical case: Male, 81-year-old with end stage renal failure undergoing hemodialysis. He received a in block kidney transplant from a 4 years old deceased donor who has brain death due to traumatic brain injury; showed no complications inherent to transplantation and renal graft function was good immediately; then he developed an atypical pneumonia, thymoma, heart failure due to severe aortic valvular stenosis, purulent cholecystitis and squamous cell carcinoma of skin; he was treated for pneumonia, an aortic valve replacement was performed and also, resection of the thymoma, cholecystectomy and resections of squamous cell carcinomas. The patient progressed satisfactorily with good kidney function until the day of his death 5 years 9 months and 25 days after transplantation. Conclusion: In block kidney transplants from very small pediatric donors in very old recipients can be performed safely and successfully and improve the quality of life and survival of these patients, like in this case.

REFERENCES

1. Hobart MG, Modlin CS, Kapoo A, et al. Transplantation of pediatric in block cadaver kidneys into adult recipients. Transplantation 1998; 66: 1689-94.

2. Tellis VA, Greenstein SM, Schechner RS, Glicklich D. Pediatric donors: still successful in adults. Transplant Proc 1990; 22: 363.

3. Bretan PN, Friese C, Goldstein RB et al. Immunologic and patient selection strategies for successful utilization of less than 15 kg pediatric donor kidneys: long-term experience with 40 transplants. Transplantation 1997; 63: 233.

4. Informe de Rendición de Cuentas de la Administración Pública Federal 2000-2006. Registro Nacional de Trasplantes, Centro Nacional de Trasplantes, Secretaría de Salud de México, CENATRA, 2006.

5. Satterthwaite R, Aswad S, Sunga V, et al. Outcome of in block and single kidney transplantation from very young cadaveric donors. Transplantation 1997; 63: 1405.

6. Hayes JM, Novick AC, Streem SB, et al. The use of single pediatric cadaver kidneys for transplantation. Transplantation 1988; 45: 106.

7. Harmon WE, Stablein D, Alexander SR, Tejani A. Graft thrombosis in pediatric transplant recipients. A report of the North American Pediatric Renal Transplant Cooperative Study. Transplantation 1991; 51: 406.

8. Terasaki PI, Gjertson DW, Cecka JM, Takemoto S, Cho YW. Significance of the donor age effect on kidney transplants. Clin Transplant 1997; 11: 366.

9. Brenner BM, Cohen RA, Milford EL. In renal transplantation, one size may not fit all. Am Soc Nephrol 1992; 3: 162.

10. Meakins JL, Smith EJ, Alexander JW. En-bloc transplantation of both kidneys from pediatric donors into adult patients. Surgery 1972; 71: 72.

11. Driekorn K, Rohl L, Horsch R. The use of double renal transplants from pediatric cadaver donors. Br J Urol 1977; 49: 361.

12. Andersen OS, Jonasson O, Merkerl FK. En-bloc transplantation of pediatric kidneys into adult patients. Arch Surg 1974; 108: 35.

13. Valderrabano F, Jones EHP, Mallik NP. Report on management of renal failure in Europe, XXIV, 1993. Nephrol Dial Transplant 1995; 10 (Suppl 5): 1.

14. Berthoux FC, Jones EHP, Mehls O, Valderrabano F. Transplantation Report 1: renal transplantation in recipients aged 60 years or older at time of grafting. Nephrol Dial Transplant 1996; 11 (Suppl 1): 37.

15. Hestin D, Frimat L, Hubert J, Renoult E, Huu TC, Kessler M. Renal transplantation in patients over 60 years of age. Clin Nephrol 1994; 42 (4): 232.

16. Vivas CA, Hickey DP, Jordan ML et al. Renal transplantation in patients 65 years old or older. J Urol 1992; 147: 990.

17. Schulak JA, Mayes JT, Johnston KH, Hricik DE. Kidney transplantation in patients aged sixty years and older. Surgery 1990; 108: 726.

18. Hefty TR. Complications of renal transplantation: the practicing urologist’s role. Lesson 8. AUA Update Series 1991; 10: 58.

19. Smith AY, van Buren CT, Lewis RM, Kerman RH, Kahan BD. Short-term and long-term function of cadaveric kidneys from pediatric donors in recipients treated with cyclosporine. Transplantation 1988; 45: 360.

20. Cho YW, Cecka JM. The pediatric donor: A multicenter review of solitary and en-bloc pediatric cadaver kidney transplants. Transplantation 1999; 67: S12.

21. Pelletier SJ, Guidinger MK, Merion RM et al. Recovery and utilization of deceased donor kidneys from small pediatric donors. Am J Transplant 2006; 6: 1646-52.

22. Cho YW, Cecka JM. The pediatric donor: A multicenter review of solitary and en-bloc pediatric cadaver kidney transplants. Transplantation 1999; 67: S12.

23. Borboroglu PG, Foster CE, Philosophe B et al. Solitary renal allografts from pediatric cadaver donors less than 2 years of age transplanted into adult recipients. Transplantation 2004; 77: 698-702.

24. Sureshkumar KK, Reddy CS, Nghiem DD et al. Superiority of pediatric en-bloc renal allografts over living donor kidneys: A long-term functional study. Clin Transpl 2006; 82: 348.

25. Mohanka R, Basu A, Shapiro R, Kayler LK. Single versus en-bloc kidney transplantation from pediatric less than or equal to 15 kg. Transplantation 2008; 86: 264-8.

26. Merkel FK. Five and 10 year follow-up of en-bloc small pediatric kidneys in adult recipients. Transplant Proc 2001; 33: 1168.

27. European Best Practice Guidelines for Renal Transplantation (Part 1). Individual risk factors. Nephrol Dial Transplant 2000; 15 (Suppl 7): 24.

28. Cameron JS. Renal transplantation in elderly. Int Urol Nephrol 2000; 32: 193.

29. Jassal JV, Opeltz G, Cole E. Transplantation in the elderly: A review. Geriatr Nephrol Urol 1997; 7: 157.

30. Bonal J, Cleries M, Velea E et al. Transplantation versus haemodialysis in elderly patients. Nehrol Dial Transplant 1997; 12: 261.