AUTHOR=Zeng Xianpeng , Xia Qiuxiang , Li Heng , Wang Miao , Li Hanying , He Liang , Su Hua , Zhang Chun , Wang Zhendi 

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

JOURNAL=Transplant International

VOLUME=Volume 38 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.14451

DOI=10.3389/ti.2025.14451

ISSN=1432-2277

ABSTRACT=En-bloc kidney transplantation from low-weight pediatric donors (≤5kg) is a challenging procedure performed only in limited transplant centers. We retrospectively analyzed the data of 42 en-bloc kidney transplantations from donors weighing less than 5kg between September, 2014 and September, 2023. The donor body weight is 3.1±1.0kg, and the minimum weight is 0.9kg. Within a mean follow-up period of 1481 days, the graft survival rate is 76.2% and the recipient survival rate is 100.0%. Thrombosis and acute rejection are the major complications responsible for the short-term graft loss. Male recipients are more likely to have graft loss than the female ones (P<0.05). The recipients with long-term (>1 year) graft survival have high prevalence (31.3%) of delayed graft function. However, they still have satisfactory long-term graft function and limited proteinuria. Continuous volume increment of the grafts last more than 1 year before reaching stable level. Lower donor/recipient body surface area might 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 high incidence of short-term graft loss, while the long-term outcome is generally acceptable.