En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience

En-bloc kidney transplantation from low-weight pediatric donors (≤5 kg) is a challenging procedure performed only in limited transplant centers. We retrospectively analyzed the data from 42 en-bloc kidney transplants from donors weighing less than 5 kg between September 2014 and September 2023. The...

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Main Authors: Xianpeng Zeng, Qiuxiang Xia, Heng Li, Miao Wang, Hanying Li, Liang He, Hua Su, Chun Zhang, Zhendi Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Transplant International
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Online Access:https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14451/full
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author Xianpeng Zeng
Qiuxiang Xia
Heng Li
Miao Wang
Hanying Li
Liang He
Hua Su
Chun Zhang
Zhendi Wang
author_facet Xianpeng Zeng
Qiuxiang Xia
Heng Li
Miao Wang
Hanying Li
Liang He
Hua Su
Chun Zhang
Zhendi Wang
author_sort Xianpeng Zeng
collection DOAJ
description En-bloc kidney transplantation from low-weight pediatric donors (≤5 kg) is a challenging procedure performed only in limited transplant centers. We retrospectively analyzed the data from 42 en-bloc kidney transplants from donors weighing less than 5 kg between September 2014 and September 2023. The mean donor body weight was found to be 3.1 ± 1.0 kg, and the minimum weight was 0.9 kg. At a mean follow-up period of 1,481 days, the graft survival rate was 76.2% and the recipient survival rate was 100.0%. Thrombosis and acute rejection were the major complications responsible for the short-term graft loss. Male recipients were more likely to experience graft loss than female ones (P < 0.05). Recipients with long-term (>1 year) graft survival were observed to have a high prevalence (31.3%) of delayed graft function. However, they still had satisfactory long-term graft function and limited proteinuria. Continuous graft volume growth took more than 1 year to reach a stable level. Lower donor/recipient body surface area may lead to higher delayed graft function and slower estimated glomerular filtration rate recovery (P < 0.05). Kidney transplant from low-weight pediatric donors is associated with a high incidence of short-term graft loss, while long-term outcomes are generally acceptable.
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spelling doaj-art-1ddf110e27ad4b919d76bcd847d6ba6a2025-08-20T03:48:03ZengFrontiers Media S.A.Transplant International1432-22772025-05-013810.3389/ti.2025.1445114451En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center ExperienceXianpeng Zeng0Qiuxiang Xia1Heng Li2Miao Wang3Hanying Li4Liang He5Hua Su6Chun Zhang7Zhendi Wang8Department of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Hepatobiliary Surgery, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Nephrology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Nephrology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaDepartment of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, ChinaEn-bloc kidney transplantation from low-weight pediatric donors (≤5 kg) is a challenging procedure performed only in limited transplant centers. We retrospectively analyzed the data from 42 en-bloc kidney transplants from donors weighing less than 5 kg between September 2014 and September 2023. The mean donor body weight was found to be 3.1 ± 1.0 kg, and the minimum weight was 0.9 kg. At a mean follow-up period of 1,481 days, the graft survival rate was 76.2% and the recipient survival rate was 100.0%. Thrombosis and acute rejection were the major complications responsible for the short-term graft loss. Male recipients were more likely to experience graft loss than female ones (P < 0.05). Recipients with long-term (>1 year) graft survival were observed to have a high prevalence (31.3%) of delayed graft function. However, they still had satisfactory long-term graft function and limited proteinuria. Continuous graft volume growth took more than 1 year to reach a stable level. Lower donor/recipient body surface area may lead to higher delayed graft function and slower estimated glomerular filtration rate recovery (P < 0.05). Kidney transplant from low-weight pediatric donors is associated with a high incidence of short-term graft loss, while long-term outcomes are generally acceptable.https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14451/fullen-blocgraft failurekidney transplantationthrombosisacute rejection
spellingShingle Xianpeng Zeng
Qiuxiang Xia
Heng Li
Miao Wang
Hanying Li
Liang He
Hua Su
Chun Zhang
Zhendi Wang
En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience
Transplant International
en-bloc
graft failure
kidney transplantation
thrombosis
acute rejection
title En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience
title_full En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience
title_fullStr En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience
title_full_unstemmed En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience
title_short En-Bloc Kidney Transplantation From Extremely Low-Weight (0.9–5.0 kg) Pediatric Donors: A Decade of Single-Center Experience
title_sort en bloc kidney transplantation from extremely low weight 0 9 5 0 kg pediatric donors a decade of single center experience
topic en-bloc
graft failure
kidney transplantation
thrombosis
acute rejection
url https://www.frontierspartnerships.org/articles/10.3389/ti.2025.14451/full
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