A NEW OPERATIVE TECHNIQUE OF PARATOPIC POSITIONING OF PEDIATRIC EN-BLOC KIDNEYS FOR TRANSPLANTATION

Technical difficulties and insufficient renal mass have been reasons n ot to use en bloc-removed kidneys from organ donors under the age of 3 years. We developed a new technique of paratopic positioning of en bl oc-removed kidneys with a prolonging interpositional graft of donor ao rta and vena cava. With transperitoneal approach, anastomosis directly to the recipient's aorta and vena cava can be performed. Using this t echnique, 7 patients have been transplanted so far. They were choosen out of a list of possible recipients according to HLA-match, body weig ht and blood pressure. All patients had primary function. Anastomosis and renal vessels were controlled by color duplex ultrasound imaging a nd angiography. Patients developed a stable kidney function. There wer e no surgical complications except a thrombosed kidney in 1 patient. W ith the new technique described, transplantation of en bloc-removed ki dneys from donors under the age of 3 years can be performed with a low rate of technical complications. Donors of this age should be conside red not only as potential liver donors but as kidney donors as well.