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Management of Surgical Complications in Pediatric Kidney Transplantation

Maria P Corzo1, Sara K Rasmussen1,2,3, Jaimie D Nathan1,2,3

  • 1Department of Abdominal Transplant and Hepatopancreatobiliary Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.

Journal of Clinical Medicine
|January 28, 2026
PubMed

Insights

Post-transplant surgical complications in pediatric kidney recipients threaten graft survival. Meticulous surgical techniques and close monitoring are crucial to prevent graft loss and improve outcomes in children undergoing kidney transplants.

Area of Science:

  • Pediatric Nephrology and Urology
  • Transplant Surgery
  • Organ Transplantation

Background:

  • Kidney transplantation in children has improved graft and patient survival.
  • However, surgical complications post-transplant occur in up to 15.4% of pediatric recipients.
  • These complications pose a significant threat to graft survival due to pediatric anatomic considerations.

Purpose of the Study:

  • To review the most common postoperative surgical complications following kidney transplantation in children.
  • To summarize the management strategies for these complications.
  • To highlight the impact of surgical complications on graft viability in pediatric kidney transplant recipients.

Main Methods:

  • A narrative review of full-text articles.
  • Searches conducted on PubMed and Google Scholar.
  • Included articles reporting pediatric kidney transplantation surgical complications and their management.

Main Results:

  • Vascular complications (1.3-13.8%) are the leading cause of graft nephrectomy, with arterial stenosis and venous thrombosis being most common.
  • Urologic complications (1.3-30%) are more frequent in children, often due to pre-existing genitourinary abnormalities; vesicoureteral reflux is the most common.
  • Surgical complications significantly impact graft viability in this population.

Conclusions:

  • Surgical complications remain a major challenge in pediatric kidney transplantation.
  • Meticulous surgical techniques and close postoperative surveillance are essential to mitigate the risk of allograft nephrectomy.
  • Further prospective studies are needed to optimize surgical practices, prevention, and postoperative care in pediatric kidney transplant recipients.

Keywords:
end stage renal diseasegraft nephrectomykidney transplant postoperative complicationsurologic complicationsvascular complications

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