Two Cases of Successful Kidney Transplantation From a 39-Year-Old Male Deceased Donor With Marfan Syndrome: A Case Series

BACKGROUND Marfan syndrome is a multisystemic, autosomal dominant connective tissue disorder caused by mutations in the fibrillin-1 gene. It is associated with life-threatening complications, especially aortic aneurysms and dissections, and has a global prevalence of 1 in 3000-5000 individuals. Although kidney transplantation is the standard treatment for end-stage renal disease (ESRD), deceased kidney donors with Marfan syndrome remain uncommon due to concerns about connective tissue fragility. Emerging reports, however, indicate that kidneys from such donors may be safely used. This report describes 2 successful kidney transplantations from a 39-year-old male donor with confirmed Marfan syndrome. CASE REPORT Case 1. The donor died from subarachnoid hemorrhage and had a history of aortic arch replacement for aortic dissection. Both kidneys were retrieved from the retroperitoneal space, prepared according to standard protocols, and stored in University of Wisconsin Store Protect Plus organ preservation solution under static cold storage at 4°C. Case 2. A 59-year-old man with ESRD secondary to diabetic nephropathy underwent his first kidney transplantation. He was hemodialyzed with residual diuresis. The right kidney was transplanted without complications, and the recipient achieved immediate and stable graft function. Case 3. The second recipient was a 34-year-old man with ESRD due to vesicoureteral reflux and obstructive nephropathy, also on hemodialysis with preserved diuresis. Left kidney transplantation proceeded uneventfully. He experienced delayed graft function, which resolved with appropriate management, resulting in satisfactory renal recovery. CONCLUSIONS These cases support the growing evidence that kidneys from donors with Marfan syndrome can function effectively after transplantation. Such donors may represent a valuable and underutilized resource, with the potential to expand the kidney donor pool safely.