Introduction: Shortage of donor organs is a rate limiting factor for kidney transplant. Innovative approaches have been used to expand the donor pool including the use of kidney grafts from small paediatric donors. There has been general reluctance to use kidneys from donors less than two years of age because of increased risk of vascular thrombosis, hyperfiltration and early graft loss. Kidneys from donors as young as 0 day old has been successfully transplanted. United Arab Emirates (UAE) deceased donor programme started in 2017. Most of the donation to date has happened from adult donors after brain death (DBD).

Method: We report, two cases of kidney donation from donors less than one year of age. The kidneys from these donors were retrieved and transplanted en bloc into adult recipients.

Results: The donors were 9-month-old male and 10-month-old female weighing 4.8 Kg and 8.5 Kg, respectively. Kidneys were retrieved en bloc following in situ hypothermic perfusion. As livers were also retrieved from these donors, the aorta and the IVC were divided just above the renal vessels. The infrarenal aorta and IVC were used to extend the aorta and IVC before en bloc implantation into adult, 32- and 49-year old female recipients, respectively. Both the recipients had primary function. Three-month creatinine were 111 umol/L and 88 umol/L and eGFR were 57 mL/min and 67 mL/min, respectively.

Conclusion: Transplantation of kidneys from small paediatric donor is a feasible option to expand the donor pool. There should be no lower age limit for paediatric kidney donation. This is the first report of kidney transplant from donors less than one year of age with successful outcome in the UAE.