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. 2021 Dec;25(8):e14102.
doi: 10.1111/petr.14102. Epub 2021 Jul 26.

Pediatric KT in children up to 15 kg: A single-center experience

Andrea Mariana Exeni  1 , German Fernando Falke  2 , Silvina Montal  3 , María Paula Rigali  1 , Débora Raquel Cisnero  1 , Leandro Berberian  2 , Sofia Marchionatti  2 , Soledad Heredia  2 , Hernán Eduardo Allegrotti  4 , Silvio Fabio Torres  5 , Ricardo Daniel Russo  2 , José Rozanec  6
Affiliations

Pediatric KT in children up to 15 kg: A single-center experience

Andrea Mariana Exeni et al. Pediatr Transplant. 2021 Dec.

Abstract

Background: KT is the preferred treatment for ESRD in pediatrics. However, it may be challenging in those weighing ≤15 kg with potential complications that impact on morbidity and graft loss.

Methods: This retrospective review reports our experience in KT in children, weighing ≤15 kg, and the strategies to reduce morbidity and mortality.

Results: All patients were on RRT prior to KT. Patients reached ESRD mainly due to urologic malformations (54.54%). LD was performed in 82% of patients. The recipient's median age was 2.83 years, and median weight 12.280 kg. Male sex was predominant (73%). All patients required transfusions of PRBCs. There was a high requirement for ventilated support in patients post-KT with no relation to weight, amount of resuscitation used intra-operatively or ml/kg of PRBCs. One patient presented with stenosis of the native renal artery. No patients presented DGF, graft thrombosis, or surgical complications. No association was found between cold ischemia and eGFR at 1 year (p = .12). In univariate analysis, eGFR at 1 year is related to AR. eGFR at 3 years is related to the number of UTI. Median follow-up was 1363 days. Patient and graft survival were 100%.

Conclusions: KT in children ≤15 kg can be challenging and requires a meticulous perioperative management and surgical expertise. Patient and graft survival are excellent with low rate of complications.

Keywords: AR; graft survival; pediatric KT; surgical complications.

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References

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