Related Experiment Video
Updated: Apr 8, 2026
Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
Renal transplantation in infants
Hannu Jalanko1, Ilkka Mattila2, Christer Holmberg3
1Department Pediatric Nephrology and Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 281, Helsinki, 00290, Finland. hannu.jalanko@hus.fi.
Insights
Pediatric renal transplantation (RTx) offers a life-saving therapy for infants with severe kidney failure, with significant improvements in survival rates. Careful pre- and post-operative care is crucial for optimal outcomes in these young patients.
Area of Science:
- Pediatric Nephrology
- Transplant Surgery
- Neonatal Medicine
Background:
- Renal transplantation (RTx) is a vital treatment for infants suffering from end-stage renal disease.
- Indications include congenital anomalies, nephrotic syndrome, polycystic kidney disease, and neonatal kidney injury.
- Early intervention and specialized care are essential for optimizing growth and preventing neurological complications.
Purpose of the Study:
- To review the indications, management, and outcomes of renal transplantation in infants.
- To highlight the critical aspects of perioperative care and long-term follow-up.
- To assess the current status and future directions of infant RTx.
Main Methods:
- Review of clinical data and outcomes from infant renal transplantation cases.
- Analysis of perioperative management strategies.
- Evaluation of long-term patient and graft survival rates.
Main Results:
- Infant RTx is feasible in neonates weighing as little as 5 kg, with most procedures performed on those weighing 10 kg or more.
- Perioperative management emphasizes allograft perfusion and prevention of thrombotic complications.
- Long-term challenges include rejection, infection, graft function, growth, bone health, metabolic issues, neurocognitive development, and quality of life.
Conclusions:
- Infant renal transplantation outcomes have significantly improved, with patient survival exceeding 90% and graft survival over 80%.
- Comprehensive management addressing medical, developmental, and psychosocial aspects is key to successful long-term outcomes.
- Continued advancements in surgical techniques and immunosuppression promise further improvements in infant RTx.
Abstract:
Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion