Zeng Xianpeng, Xia Qiuxiang, Li Heng, Wang Miao, Li Hanying, He Liang, Su Hua, Zhang Chun, Wang Zhendi
Department of Urology, Huazhong University of Science and Technology Union Hospital, Wuhan, China.
Department of Hepatobiliary Surgery, Huazhong University of Science and Technology Union Hospital, Wuhan, China.
Transpl Int. 2025 May 20;38:14451. doi: 10.3389/ti.2025.14451. eCollection 2025.
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 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.
来自低体重小儿供体（≤5千克）的肾移植是一项仅在少数移植中心开展的具有挑战性的手术。我们回顾性分析了2014年9月至2023年9月期间42例接受体重小于5千克供体肾移植的数据。发现供体平均体重为3.1±1.0千克，最小体重为0.9千克。平均随访期为1481天，移植肾存活率为76.2%，受者存活率为100.0%。血栓形成和急性排斥是导致短期移植肾丢失的主要并发症。男性受者比女性受者更易发生移植肾丢失（P<0.05）。观察到长期（>1年）移植肾存活的受者中移植肾功能延迟发生率较高（31.3%）。然而，他们的长期移植肾功能仍令人满意，蛋白尿有限。移植肾体积持续增长超过1年才达到稳定水平。供体/受者较低的体表面积可能导致较高的移植肾功能延迟和较慢的估计肾小球滤过率恢复（P<0.05）。来自低体重小儿供体的肾移植短期移植肾丢失发生率较高，而长期预后总体上可以接受。
