Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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10:09 - 10:12
S6-2 (PP)
RENAL TRANSPLANT IN CHILDREN WEIGHING 15 KG OR LESS: TECHNICALLY
DEMANDING BUT FEASIBLE.
Romy GANDER1, Marino ASENSIO1, Gloria Fatou ROYO1, Jose Andrés MOLINO2, Laura GARCÍA2, Nerea VICENTE2, Luis
Enrique LARA3, Gema ARICETA3 and Josep LLORET2
1) University Hospital Vall d'Hebron Barcelona, Pediatric Surgery. Pediatric Urology Unit, Barcelona, SPAIN - 2)
University Hospital Vall d'Hebron Barcelona, Pediatric Surgery, Barcelona, SPAIN - 3) University Hospital Vall d'Hebron
Barcelona, Pediatric nephrology, Barcelona, SPAIN
PURPOSE
Pediatric renal transplantation (RT) in children with low-weight is related to potential surgical complications that may
cause severe morbidity and graft loss.The aim ouf our study was to analize the outcome of RT recipients weighing 15 kg
or less, focused on surgical complications, associated morbidity and mortality, as well as allograft loss.
MATERIAL AND METHODS
We reviewed our retrospective institutional database for recipients of pediatric RT performed between january 2000 and
december 2014 who weighing 15 kg or less.
RESULTS
There were a total of 164 pediatric RT, 45 (27.4% ) weighing 15 kg or less. One patient was excluded due to lack of
vascular access which precluded RT. As a result, our study population comprised 44 children. Twenty-three (52.3%)
weighed 10 kg or less. Mean weight was 10.10 kg (SD: 2.96). All allografts came frome deceased pediatric donors. Two
patients received a liver transplant simultaneously. The allograft was implanted intraperitoneal in 2 patients (4.5%) of
extremely low weight (3.2 and 3 kg,respectively) and extraperitoneal in the remaining 42 (95.5%).
Mean operative time was 190 minutes (SD:47.32) and mean warm ischemia 51.02 minutes (SD: 17.94). Postoperative
complications appeared in 10, and 8 required reintervention.Four (9.1%) allografts were lost secondary to surgical
complications (3 vascular thrombosis and 1 primary graft disfunction). Despite 3 (6.8%) patients died, only one was
related to surgical complications. No significant differences in surgical complications were observed when compared with
patients of > 15kg (p>0.05). Actuarial graft survival was 94% and 85%, at 1 and 5 years, respectively. No significant
differences in graft survival were observed when compared with patients of > 15kg (p>0.05). Mean follow-up was 75
months (SD: 49.14).
CONCLUSIONS
RT in children weighing 15 kg or less is technically demanding but feasible without increased risk of surgical
complications or graft loss.