Postoperative surgical complications after pediatric kidney transplantation in low weight recipients (<15 kg): a systematic review.

Purpose of review: Kidney transplantation in low-weight recipients (<15 kg) is a challenging surgery with special characteristics. We proposed to perform a systematic review to determine the postoperative complication rate and the type of complications after kidney transplantation in low-weight recipients (<15 kg). The secondary objectives were to determine graft survival, functional outcomes, and patient survival after kidney transplantation in low-weight recipients.

Methods: A systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses. Medline and Embase databases were searched to identify all studies reporting outcomes on kidney transplantation in low-weight recipients (<15 kg).

Results: A total of 1254 patients in 23 studies were included. The median postoperative complications rate was 20.0%, while 87.5% of those were major complications (Clavien ≥3). Further, urological and vascular complications rates were 6.3% (2.0-11.9) and 5.0% (3.0-10.0), whereas the rate of venous thrombosis ranged from 0 to 5.6%. Median 10-year graft and patient survival were 76 and 91.0%.

Summary: Kidney transplantation in low-weight recipients is a challenging procedure complicated by a high rate of morbidity. Finally, pediatric kidney transplantation should be performed in centers with expertise and multidisciplinary pediatric teams.