title: Kidney transplantation in children weighing less than 15 kg: extraperitoneal surgical access-experience with 62 cases.
abstract: Small children are a challenging group in whom to perform KT. This retrospective study analyzed the results of 62 KTs in children weighing <15 kg, performed between 1998 and 2010, using extraperitoneal access and anastomosis of the renal vessels of donors to the aorta and IVC or iliac vessels of the recipients. Thirty-two (51.6%) grafts were LRDTs and 30 (48.4%) were DDRTs-28 of them pediatric. The mean age at KT was 3.7 ± 2.2 yr (1-12), and the mean weight was 12.3 ± 2.1 kg (5.6-14.9). Ten children weighed <10 kg, and five (8.1%) children presented previous thrombosis of the venous system. At one and five yr, patient survival was 93.2% and 84.2%, and graft survival was 85.2% and 72.7%. There were no differences between the rates for LRDT and DDRT. There were six vascular complications (four vascular thromboses, one laceration, and one renal artery stenosis) and two perirenal collections. Extraperitoneal access is a valid KT technique in children weighing <15 kg.
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Cirúrgicas, Porto Alegre, Brazil. spvitola@terra.com.br
authors.forename: S P
authors.initials: SP
authors.lastname: Vitola
authors.forename: D
authors.initials: D
authors.lastname: Gnatta
authors.forename: V D
authors.initials: VD
authors.lastname: Garcia
authors.forename: C D
authors.initials: CD
authors.lastname: Garcia
authors.forename: V B
authors.initials: VB
authors.lastname: Bittencourt
authors.forename: E
authors.initials: E
authors.lastname: Keitel
authors.forename: F S
authors.initials: FS
authors.lastname: Pires
authors.forename: A R
authors.initials: AR
authors.lastname: D'Avila
authors.forename: J G
authors.initials: JG
authors.lastname: Silva
authors.forename: R L
authors.initials: RL
authors.lastname: Amaral
authors.forename: L N
authors.initials: LN
authors.lastname: Santos
authors.forename: C D P
authors.initials: CD
authors.lastname: Kruel
mesh_terms: D000714:Anastomosis, Surgical; D001011:Aorta / Q000601:surgery; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007084:Iliac Vein / Q000601:surgery; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007668:Kidney / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D051437:Renal Insufficiency; D012189:Retrospective Studies; D013927:Thrombosis / Q000473:pathology; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery
chemical_list: D007166:Immunosuppressive Agents
keywords: graft survival; pediatric kidney transplantation; surgical complications