Background: Deceased donor availability is a limiting factor for meeting the demands for kidney transplant. Advanced age and a high Kidney Donor Profile Index (KDPI) predicts an inferior medium-long term graft survival. Kidneys from small paediatric donors, particularly those under two years of age are not widely utilized because of the increased risk of vascular complications and premature graft failure. Meticulous assessment of each deceased donor at these extremes of ages and innovative techniques such as dual and en bloc kidney transplant (DKT and EKT) result in transplanting these kidneys with acceptable outcome and expanding the donor pool.
Methods: Deceased donor program was started in the United Arab Emirates in 2017 following the approval of deceased donor legislation. After a slow start and then the negative impact of Covid19, the program is beginning to accelerate. We report our initial experience of DKT and EKT over one year (Dec 2022-Nov 2023) utilizing donor kidneys that were declined by multiple centres.
Results: Five patients underwent kidney transplant from deceased donors that were declined by multiple centres in the UAE, 2 EKT, 3 DKT & are described below (table 1). All patients have shown acceptable graft function at a variable follow up periods (2-12m).

Conclusion: With careful assessment kidneys from donors at extremes of age & high KDPI can be transplanted into suitable recipients with acceptable outcome. Both kidneys from a single donor are transplanted in to one recipient to provide adequate nephron mass (age and KDPI) and to avoid vascular complications (small paediatric donors). In this context, no age or a KDPI value should be regarded as an absolute contraindication to kidney transplant. This is the first report of EKT and DKT in the UAE.