Pediatric Renal Transplantation: A 10-Year Single-Center Experience

Transplant Proc. 2025 Sep;57(7):1277-1280. doi: 10.1016/j.transproceed.2025.07.014. Epub 2025 Aug 22.

Abstract

Introduction: Pediatric renal transplantation is a life-saving procedure for children with end-stage renal disease (ESRD), offering superior long-term outcomes compared to dialysis, including improved quality of life and survival.

Objective: The aim of this study is to present a tertiary center experience, over a 10-year period as a specialized center for kidney transplants in children.

Methods: We retrospectively reviewed data from 35 pediatric kidney transplant recipients between 2015 and 2024 from a single Portuguese center.

Results: The median age at transplantation was 12 years (range 3-18). The most common underlying condition was congenital anomalies of the kidney and urinary tract (CAKUT) (43.5%), followed by glomerular diseases, Alport syndrome, prematurity-related nephropathy, and idiopathic chronic kidney disease. Dialysis was performed in 25 patients (71.4%) before transplantation: 12 underwent peritoneal dialysis, 10 hemodialysis, and 4 both modalities, with a mean duration of 14.3 months. Most grafts (88.6%) were from deceased donors, with the right kidney used in 60% of cases. The median cold ischemia time was 9 and a half hours. Immediate graft function was achieved in 77.1% of cases; graft failure occurred in 14.3%. Hypertension and diabetes were the most common early complications, while late complications included infections and recurrence of the primary disease.

Conclusion: Pediatric kidney transplantation remains a complex yet effective treatment option, offering satisfactory long-term graft function and manageable complications in a specialized center.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / methods
  • Male
  • Portugal
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome