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En-bloc paediatric dual kidney transplantation in Hong Kong: a case series and literature review.

En-bloc paediatric dual kidney transplantation presents specific challenges but provides a viable option for patients with end-stage renal disease. In this case series, we report four cases of paediatric cadaveric en-bloc donor kidney transplantation and review the literature on reported complications and functional outcomes of this procedure. From 2001 to 2015, there were four paediatric cadaveric en-bloc donor kidney transplantation procedures undertaken in Hong Kong. Deceased donors’ mean age was 3.6 ± 2.6 years and recipients’ mean age was 26.3 ± 16.3 years. Mean total operating time was 214 ± 28.2 minutes, mean cold ischaemic time was 222 ± 150 minutes, mean warm ischaemic time was 26 ± 11.3 minutes, and mean graft kidney volume was 156.3 ± 31.3 mL. The Table provides a summary of individual donor and recipient information. The kidneys were retrieved en bloc with the donor’s aorta and vena cava. The proximal end of the aorta and vena cava was oversewn at the supra-renal level and the ureters were transected as close to the bladder as possible. Recipients were prepared for extra-peritoneal implantation with modified Gibson’s incision. The distal ends of the aorta and vena cava were anastomosed to the recipient’s external iliac artery and external iliac vein respectively in an endHong Kong Med J 2018;24:532–4 DOI: 10.12809/hkmj166061