Pediatric Renal Transplantation: A 10-Year Single-Center Experience

Pediatric renal transplantation is a life-saving procedure for children with end-stage renal disease (ESRD), offering superior long-term outcomes compared to dialysis, including improved quality of life and survival.

The aim of this study is to present a tertiary center experience, over a 10-year period as a specialized center for kidney transplants in children.

We retrospectively reviewed data from 35 pediatric kidney transplant recipients between 2015 and 2024 from a single Portuguese center.

The median age at transplantation was 12 years (range 3-18). The most common underlying condition was congenital anomalies of the kidney and urinary tract (CAKUT) (43.5%), followed by glomerular diseases, Alport syndrome, prematurity-related nephropathy, and idiopathic chronic kidney disease. Dialysis was performed in 25 patients (71.4%) before transplantation: 12 underwent peritoneal dialysis, 10 hemodialysis, and 4 both modalities, with a mean duration of 14.3 months. Most grafts (88.6%) were from deceased donors, with the right kidney used in 60% of cases. The median cold ischemia time was 9 and a half hours. Immediate graft function was achieved in 77.1% of cases; graft failure occurred in 14.3%. Hypertension and diabetes were the most common early complications, while late complications included infections and recurrence of the primary disease.

Pediatric kidney transplantation remains a complex yet effective treatment option, offering satisfactory long-term graft function and manageable complications in a specialized center.