Pediatric Transplantation最新文献

{"title":"Recurrence of Primary Sclerosing Cholangitis After Pediatric Liver Transplantation: A Single-Center, Retrospective Study in Japan.","authors":"Athaya Vorasittha, Seisuke Sakamoto, Yusuke Yanagi, Kazuki Degawa, Hirotaka Kato, Tasuku Kodama, Ryuji Komine, Masaki Yamada, Hajime Uchida, Akinari Fukuda, Chiduko Haga, Takako Yoshioka, Mureo Kasahara","doi":"10.1111/petr.70078","DOIUrl":"https://doi.org/10.1111/petr.70078","url":null,"abstract":"<p><strong>Aim: </strong>Liver transplantation (LT) is a well-accepted treatment for primary sclerosing cholangitis (PSC) with generally good outcomes, although recurrent PSC (rPSC) poses significant challenges. This study aimed to describe patient characteristics and identify potential risk factors of rPSC in pediatric LT recipients.</p><p><strong>Methods: </strong>This retrospective study analyzed 13 pediatric patients who underwent LT for PSC at a single center. Patient characteristics, risk factors, and outcomes were compared between those with and without rPSC.</p><p><strong>Results: </strong>The median age at PSC diagnosis was 5.2 years and at LT, 15.4 years. Inflammatory bowel disease (IBD) was present in 12 patients (92.3%), and four (30.7%) had overlapping autoimmune hepatitis (AIH) before LT. Two patients received grafts from living-related donors, and 11 from deceased donors. During a median follow-up of 53 months, 4 of the 13 patients (30.7%) developed rPSC at a median of 48.9 months post-LT. Patients with rPSC tend to be younger at PSC diagnosis. All rPSC cases were associated with IBD, and half had AIH overlap, though the frequency difference was not significant. Acute cellular rejection (ACR) was universal in rPSC patients (100%) compared to nonrecurrent cases (33.3%, p = 0.07). One case of rPSC developed pulmonary hypertension following rPSC and succumbed to PH crisis, resulting in a 5-year patient survival rate of 82%.</p><p><strong>Conclusions: </strong>The recurrence rate was high in pediatric patients with PSC. The observed association with immune-activating conditions raises the possibility of utilizing immunologic interventions to prevent rPSC, although further prospective studies are warranted to clarify the underlying mechanisms.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70078"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short and Long-Term Outcomes of Liver Transplantation in Pediatric Patients With Inborn Errors of Metabolism: A Single-Center Study.","authors":"Hazel Delal Dara Kar, Halil İbrahim Aydın, Figen Özçay, Oya Balcı Sezer, Esra Baskın, Feride Şahin, Yunus Kasım Terzi, Emre Karakaya, Mehmet Haberal","doi":"10.1111/petr.70067","DOIUrl":"10.1111/petr.70067","url":null,"abstract":"<p><strong>Background: </strong>Inborn errors of metabolism (IEMs) are inherited diseases causing significant morbidity and mortality, particularly in childhood. Liver transplantation (LT) can be curative or partially effective for these diseases. LT for IEMs has increased, making IEMs the second most common reason for pediatric LT after biliary atresia.</p><p><strong>Patients and methods: </strong>Between 2001 and 2023, 50 pediatric patients with IEMs underwent LT at Başkent University, Ankara Hospital. Data collected retrospectively included diagnosis, gender, age of diagnosis, age of LT, LT indication, donor data, graft type, rejection episodes, post-transplant complications, and clinical findings of the IEMs before and after LT. Treatment methods, follow-up duration, and survival time were also recorded.</p><p><strong>Results: </strong>Of the 332 pediatric LT patients, 50 (15.1%) had IEMs, with three requiring re-transplantations. Diagnoses included glycogen storage diseases (n = 11), tyrosinemia type 1 (n = 10), primary hyperoxaluria (n = 6), urea cycle disorders (n = 6), homozygous familial hypercholesterolemia (n = 4), propionic acidemia (n = 4), deoxyguanosine kinase deficiency (n = 3), maple syrup urine disease (n = 2), methylmalonic acidemia (n = 1), Niemann-Pick disease type B (n = 1), alkaptonuria with unknown neonatal cholestasis (n = 1), and bile acid synthesis disorder (n = 1). The parental consanguinity rate was 74%. Living-related donors provided organs for 48 (90.5%) patients. The mean age at LT was 75.3 ± 8.2 months (range: 5-218), with a follow-up period of 82.1 ± 10.2 months (range:1 day-229 months). Survival rates at 1, 5, 10, and 15 years were 83.7%, 81%, 81%, and 70.9%, respectively.</p><p><strong>Conclusion: </strong>LT is an effective solution for children with IEM causing chronic organ failure and difficult to manage with medical treatment, showing a good long-term prognosis.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70067"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedure Costs Associated With Management of Biliary Strictures in Pediatric Liver Transplant Recipients in the Society of Pediatric Liver Transplantation (SPLIT) Registry.","authors":"Pamela L Valentino, James D Perkins, Sarah A Taylor, Amy G Feldman, Anna M Banc-Husu, Douglas S Fishman, John C Bucuvalas, Regino P Gonzalez-Peralta, George Mazariegos, Bhargava Mullapudi, Vicky L Ng, Shikha S Sundaram, Nada A Yazigi, Jennie Kennedy, Kyle Soltys","doi":"10.1111/petr.70009","DOIUrl":"10.1111/petr.70009","url":null,"abstract":"<p><strong>Background: </strong>Biliary strictures (BS) remain a challenge in pediatric liver transplant (LT). Achievement of the \"Optimal Biliary Outcome\" (OBO), stricture resolution without recurrence or surgery is the goal. We analyzed cost associated with different management.</p><p><strong>Methods: </strong>Society of Pediatric LT (SPLIT) data were matched with Pediatric Health Information System (PHIS) data by dates of birth and transplant, center and sex. SPLIT data were used to identify LT recipients (2011-2016) with BS. Procedure and admissions costs from PHIS were inflation-adjusted to 2022. Sub-analyses evaluated costs associated with achieving OBO.</p><p><strong>Results: </strong>Optimal biliary outcome was achieved in 42% of 77 participants following a median of 4 procedures and 2 inpatient nights compared to a median of 7 procedures and 4 nights in those without OBO (p < 0.001). BS management was lower in participants who achieved OBO versus who did not achieve OBO (p = 0.004). Significant center variation in cost was observed (p < 0.001). Biliary strictures diagnosed earlier post-PLT were associated with lower costs per patient (p = 0.049), while those who underwent surgical biliary revision did not incur higher costs per patient (p = 0.17). In participants who did not achieve OBO and underwent ≥ 6 PTC procedures tended to incur much higher costs compared to those who underwent ≤ 5 PTC procedures, regardless of surgical biliary revision (p = 0.08).</p><p><strong>Conclusions: </strong>Biliary stricture management costs were highest in patients requiring treatment for recurrence or surgical biliary revision and lowest earlier post-transplant, suggesting that more aggressive management upfront may optimize costs. Future work will explore practice variation and cost-effective strategies to achieve OBO.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70009"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden in CAKUT: Post-Transplant Diagnosis of Primary Hyperoxaluria Type 1 and Rescue Management Using Lumasiran.","authors":"Hebatallah Bahbah, Ahmed Azzam, Ammar Hamed, Najla Aldaoud, Alanoud Alshami","doi":"10.1111/petr.70079","DOIUrl":"https://doi.org/10.1111/petr.70079","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperoxaluria type 1 (PH1) is a very rare inherited metabolic disorder characterized by excessive oxalate production due to mutation variants in the alanine-glyoxylate aminotransferase gene (AGXT). Approximately 4% of PH1 cases are diagnosed after kidney transplantation. Most post-transplant recurrences of PH1 are associated with poor graft outcomes. Lumasiran, a novel RNA interference (RNAi) therapeutic for PH1, was recently discovered with promising results.</p><p><strong>Methods: </strong>This report describes a pediatric case of PH1 diagnosed post-kidney transplantation with graft dysfunction who was treated with extensive hemodialysis and lumasiran as rescue therapy.</p><p><strong>Results: </strong>Patient was able to stop hemodialysis with the improvement of her kidney function and plasma oxalate after the fourth dose of lumasiran.</p><p><strong>Conclusion: </strong>This case underscores the importance of maintaining a high index of suspicion for PH1 in patients with congenital anomalies of the kidney and urinary tract (CAKUT) or unexplained end-stage kidney disease (ESKD) cases, even post-transplantation. It also demonstrates the potential efficacy of lumasiran in managing PH1 post-transplantation when combined with intensive hemodialysis and supportive care. However, more studies with prolonged follow-up periods are necessary to establish the long-term efficacy and safety of lumasiran in the treatment of PH1 without the requirement for liver transplantation.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70079"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Risk factors of hypothermia during pediatric liver transplantation using a novel warming method\".","authors":"","doi":"10.1111/petr.70083","DOIUrl":"https://doi.org/10.1111/petr.70083","url":null,"abstract":"","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70083"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seraph 100 Microbind Affinity Blood Filter for Persistent Pediatric BK Virus Nephropathy.","authors":"Meredith Harris, Mahima Keswani, Theresa Mottes, Taylor Heald-Sargent, Priya S Verghese","doi":"10.1111/petr.70055","DOIUrl":"10.1111/petr.70055","url":null,"abstract":"<p><strong>Background: </strong>Resolution of BK viremia is almost universally required before kidney transplant. Unfortunately, proven anti-BK viral therapies are limited. The Seraph 100 mimics the action of the natural glycocalyx, which binds pathogens via heparin sulfate proteoglycans. In this case report, we describe the use of this filter to facilitate the clearance of BK viremia.</p><p><strong>Methods: </strong>Our patient was a 14-year-old cardiac transplant recipient secondary to familial dilated cardiomyopathy. She developed BK nephropathy resulting in end stage kidney disease (ESKD). After failed medical management and immunoreduction over 4 years, the Seraph 100 Microbind Affinity Blood Filter was utilized extracorporeally in line with continuous renal replacement therapy (CRRT) for 48 h to eliminate detectable BK viral replication.</p><p><strong>Results: </strong>The patient's BK titers initially increased negligibly but cleared within 2 months of Seraph 100 treatment, and she successfully underwent kidney transplantation without recurrence of BK viremia. There were no adverse events other than one episode of emesis at the initiation of CRRT.</p><p><strong>Conclusion: </strong>Our case provides proof of concept and feasibility for studying the Seraph 100 as a potential therapeutic option for the clearance of BK viral titers, especially in ESKD patients who already have dialysis access.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70055"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Dosing, Therapeutic Drug Monitoring, and Clinical Pharmacokinetics in Pediatric Kidney Transplant Patients: Principles and Practice With Emphasis on Low- and Middle-Income Countries.","authors":"Paulo Caceres Guido, Guillermo Federico Taboada, Marta Lidia Monteverde","doi":"10.1111/petr.70074","DOIUrl":"10.1111/petr.70074","url":null,"abstract":"<p><strong>Background: </strong>Pediatric kidney transplantation requires complex multidisciplinary coordination. The contributions of pharmacotherapeutic aspects to this practice have been of fundamental importance, even in low- and middle-income countries (LMIC).</p><p><strong>Methods: </strong>We conducted a quasi-systematic review of the PubMed and Google Scholar databases from inception to July 2024 using Medical Subject Headings and keywords relevant to Therapeutic Drug Monitoring (TDM) and Model-Based Precision Dosing (MIPD). The quality of the articles and data collected were appraised using the appropriate critical appraisal tools and was synthesized qualitatively.</p><p><strong>Results: </strong>TDM and the analyses and interpretations associated with pharmacometric aspects, specifically clinical pharmacokinetics, have led to the use of modern strategies such as MIPD. These strategies allow for individually adjusted drug dosages to be optimized, making them more effective and safer for many immunosuppressants, antibiotics, antivirals, antifungals, antiepileptics, antineoplastics, and antiarrhythmics, among others. Several points of interest associated with improving the implementation and practice of TDM-MIPD, particularly challenging in LMICs, include the availability and adequate management of economic resources (such as software and laboratory supplies), the development of collaborative work with other institutions (including foreign ones), the possibility of consolidating independent management not depending on other clinical services, the need to train and maintain highly skilled professional staff for clinical and research purposes, and the establishment and maintenance of specialized educational programs.</p><p><strong>Conclusion: </strong>Throughout the world, but especially in LMICs, there is a need to intensify strategies that allow for the more widespread application of TDM-MIPD to improve pharmacotherapeutic care for this highly vulnerable patient population.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70074"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABO Incompatible Grafts Are Associated With Excellent Outcomes in Pediatric Liver Transplant Recipients: An Important Resource to Reduce Waitlist Mortality.","authors":"Pamela L Valentino, Patrick J Healey, James D Perkins, Biren Desai, Hugo Quezada, Niviann M Blondet, André A S Dick, Idoia Gimferrer, Simon P Horslen, Evelyn K Hsu, Yong K Kwon, Katelyn M Saarela, Mark L Sturdevant, Danielle Wendel, Jorge D Reyes","doi":"10.1111/petr.70047","DOIUrl":"10.1111/petr.70047","url":null,"abstract":"<p><strong>Background: </strong>Liver transplant (LT) waitlist mortality occurs in 10% of children; innovative strategies to expand access to LT can be lifesaving.</p><p><strong>Methods: </strong>Outcomes of ABO incompatible (ABOi) LT performed between 1999 and 2023 at a high-volume center were compared to ABO compatible (ABOc) LT.</p><p><strong>Results: </strong>25 ABOi LT were performed among 270 LT; 72% were listed with status 1/1A/1B or a median pediatric end-stage liver disease/model for end-stage liver disease of 40 (IQR 32,41). Time on the waitlist for ABOi recipients was shorter (median 11 days [IQR 4,46]) compared to ABOc (113 days [IQR 39,252], p < 0.001). ABOi graft types were 64% technical variants (including 2 living donor grafts) and 36% whole; 52% received a duct-duct biliary anastomosis. There were no statistically significant differences in 1/5/10-year patient survival [ABOi: 87,87,87% vs. ABOc: 96,94,89%, p = 0.6] or graft survival [ABOi: 87,82,82% vs. ABOc: 92,86,80%, p = 0.9]. When compared to ABOc, there were no statistically significant differences in vascular complications, bile leaks, or acute T-cell-mediated rejection with ABOi LT. Biliary strictures were diagnosed in 43% of ABOi LT and more frequently than in ABOc (20%, p = 0.0495).</p><p><strong>Conclusions: </strong>ABOi LT can offer children on the waitlist a survival advantage through shorter waiting time. ABOi LT can be performed safely with a low rate of vascular complications similar to ABOc LT.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70047"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting the Challenges of Post-Transplant Lymphoproliferative Disorders After Liver Transplantation in Children: A Proposed Diagnostic and Management Algorithm.","authors":"Nathalie Marie Rock, Antonin Bouroumeau, Danai Papangelopoulou, Ismini Mainta, Eirini Katirtzidou, Isabelle Dupanloup, Barbara E Wildhaber, Arnaud G L'Huillier, Marc Ansari, Valérie Anne McLin, Frederic Baleydier, Anne-Laure Rougemont","doi":"10.1111/petr.70060","DOIUrl":"https://doi.org/10.1111/petr.70060","url":null,"abstract":"<p><strong>Background: </strong>Post-transplant lymphoproliferative disorders (PTLD) may significantly impair outcomes in children after solid organ transplantation (SOT). Diagnosis and treatment may be challenging. We analyze a representative pediatric liver transplant (LT) cohort in light of these challenges.</p><p><strong>Methods: </strong>Pediatric LT recipients monitored by the Swiss Pediatric Liver Center from 2009 to 2021 with a suspicion of Epstein-Barr virus (EBV) driven PTLD were included. All cases were retrospectively reviewed using the World Health Organization (WHO) 2022 classification criteria for Pediatric Tumors. Two groups were defined: (1) histologically confirmed PTLD, and (2) 'indeterminate PTLD' if criteria were not entirely met.</p><p><strong>Results: </strong>During the inclusion period, 111 patients underwent LT. Histology review confirmed PTLD in 13 patients (11.7%) while 3 patients were included in the 'indeterminate' group. The most common subtype was non-destructive PTLD (6/13), followed by monomorphic (4/13) and polymorphic PTLD (3/13). Hypermetabolism on whole body (¹⁸F) fluorodeoxyglucose PET/CT helped define adequate biopsy location in 11/13 patients. Three patients with monomorphic PTLD also showed low-grade PTLD subtypes in other biopsy sites. Nine patients received mTOR inhibitors after diagnosis, either as monotherapy or in combination with calcineurin inhibitors, without major side effects.</p><p><strong>Conclusions: </strong>The detailed analysis of our series of pediatric LT patients with PTLD allowed for the development of a diagnostic and management algorithm, now applied at our institution. Spatial and temporal heterogeneity argues in favor of multiple and, if necessary, repeated biopsies at different sites.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70060"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Bilateral Pediatric Nephrectomies: Indications, Approach and Outcomes Over a 15-Year Period.","authors":"A M Lombardo, M Stout, A Zann, D McLeod, S Alpert, V R Jayanthi, D DaJusta, C B Ching","doi":"10.1111/petr.70072","DOIUrl":"10.1111/petr.70072","url":null,"abstract":"<p><strong>Background: </strong>Reports on bilateral simultaneous native nephrectomies in the pediatric population are lacking. This study evaluates indications and outcomes of a tertiary care pediatric hospital's single center experience with bilateral simultaneous native nephrectomies over 15 years.</p><p><strong>Methods: </strong>A retrospective chart review of pediatric patients (< 21 years old) who underwent bilateral simultaneous native nephrectomy from January 1, 2009, to August 1, 2024, at a single institution was performed for surgical indications, approach, and outcomes.</p><p><strong>Results: </strong>Ten patients were identified. Mean age at bilateral simultaneous nephrectomy was 9.6 years (range 14 months-19 years). Surgical indications included hypertensive crisis in four, nephrotic syndrome in three, Polycythemia Vera in one, recurrent urinary tract infections (UTI) in one, and significant hydroureteronephrosis in one patients. Prior to nephrectomy, six patients were on hemodialysis, two patients were on peritoneal dialysis (PD), and two patients were not on any form of dialysis. Of the 10 patients, four underwent surgery during an inpatient admission for an acute exacerbation of the listed indication. Three cases were done robotically (transperitoneal), and seven were performed open. Both patients on PD preoperatively underwent open retroperitoneal surgery and were able to restart PD on postoperative day 1. There was one complication in a patient with recurrent UTIs who developed an intra-abdominal abscess, requiring percutaneous drainage.</p><p><strong>Conclusions: </strong>Bilateral simultaneous native nephrectomy is a safe and effective way to manage conditions associated with end-stage renal disease in pediatric patients. In our experience, this can be done by an open or minimally invasive approach.</p>","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":"29 3","pages":"e70072"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}