En bloc dual kidney transplantation from paediatric donors in Sri Lanka

Introduction: Kidney transplantation is the optimal treatment for patients with end-stage kidney disease (ESKD). However, the shortage of donor organs remains a major limitation. The use of kidneys from paediatric deceased donors is one strategy to expand the donor pool. En bloc dual kidney transplantation (EBKT), in which both kidneys are transplanted together with the donor aorta and inferior vena cava, has been developed to overcome concerns related to small renal mass and vascular complications.
Case series: We report three cases of en bloc dual kidney transplantation from paediatric deceased donors performed in Sri Lanka. Donor ages ranged from three to seven years (mean age 5.25 years), with body weights between 12 kg and 14.5 kg (mean weight 13.25 kg). The grafts were transplanted into adult recipients with end-stage renal disease. In all cases, the donor aorta and inferior vena cava were anastomosed to the recipient’s external iliac vessels. Two recipients demonstrated immediate graft function, while one developed transient acute tubular necrosis with subsequent recovery. All recipients were discharged with satisfactory graft function.
Conclusion: This case series demonstrates that en bloc dual kidney transplantation from paediatric donors is a feasible and safe option with favourable early graft outcomes. It may represent a valuable strategy to expand the donor pool in resource-limited settings such as Sri Lanka.