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- W3168000977 abstract "IntroductionKidney transplantation (KTx) is the most effective treatment for end-stage renal disease in children.ObjectivesWe aimed to compare the long-term outcomes and surgical complications of the intraperitoneal approach (IPA) and extraperitoneal approach (EPA) for KTx in children weighing <15 kg.Study designWe performed a retrospective cohort study on pediatric kidney transplant recipients, weighing <15 kg, who received their first living-related kidney transplant between January 1987 and December 2015. Patients were divided into two groups based on the surgical approach (IPA or EPA) during transplant, and clinical data were extracted from the medical records.ResultsThe median follow-up duration was 14.1 years (interquartile range, 9.0–19.2). Comparing the two groups (IPA group, n = 62; EPA group, n = 38), the median age and body weight were significantly lower in the IPA group (4.2 vs. 4.8 years, P = 0.03; 11.7 vs. 13.0 kg, P < 0.01). There were 26 surgical complications (26%) in 19 patients during the follow-up period. The surgical complication rate was higher in the IPA group (39% vs. 6%).DiscussionWe assessed the long-term outcomes of the surgical approaches used for pediatric patients weighing <15 kg who underwent KTx and received a size-mismatched adult donor kidney. There was no significant difference in renal transplantation prognosis using the surgical approach, but IPA-related complications were more frequent in the long term. Therefore, our data suggest that in cases of donor-recipient size mismatch in pediatric KTx, the EPA, associated with fewer surgical complications, is preferable to the IPA if the patient's body size has sufficient space for allograft placement.ConclusionSummary TableComparison of surgical complications by surgical approach.VariablesIPA group (n = 62)EPA group (n = 38)P-valueEarly surgical complications15 (24%)1 (3%)<0.01Urinary leak30Urinary stenosis10Ileus20Renal artery thrombosis10Renal vein thrombosis10Anastomotic bleeding10Lymphocele10Wound infection10Renal allograft compression syndrome41Late surgical complications9 (15%)1 (3%)0.08Ileus60Bowel obstruction20Urinary stenosis01 Bladder stone (due to sutures)10Total24 (39%)2 (6%)<0.01Surgical reintervention10 (16%)1 (3%)0.05EPA, extraperitoneal approach; IPA, intraperitoneal approach; KTx, kidney transplantation.Values are presented as numbers (%). Early surgical complications were identified within 30 days post-KTx. Late surgical complications were defined as complications occurring more than 1 month post-KTx. Open table in a new tab" @default.
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- W3168000977 date "2021-08-01" @default.
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- W3168000977 title "Long-term outcomes of living-donor kidney transplant children weighing less than 15 kg: Comparison of the surgical approach" @default.
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- W3168000977 doi "https://doi.org/10.1016/j.jpurol.2021.05.021" @default.
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