What does this research mean for the field?

Single pediatric kidney grafts from donors weighing ≤20 kg provide excellent long-term graft survival, though grafts from donors weighing <15 kg carry a significantly higher risk of primary nonfunction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to evaluate the outcomes of single kidney grafts from pediatric donors and their association with donor weight.

July 4, 2026Open Access

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Outcomes of Single Pediatric Kidney Grafts: An Experienced Single-center Retrospective Study

Q: What question did this study set out to answer?

The aim is to evaluate the outcomes of single kidney grafts from pediatric donors and their association with donor weight.

PSPatrick J. SurUniversity of California Davis Medical Center NDNoor DawanyChildren's Hospital of Philadelphia YKYvonne KellyUniversity College Dublin

Key Points

The aim is to evaluate the outcomes of single kidney grafts from pediatric donors and their association with donor weight.
Single-center retrospective review of pediatric kidney transplants from 2005 to 2023.
Recipients were grouped by donor weight: <15 kg and ≥15 kg.
Data analyzed included demographics, graft outcomes, and transplant procedures.
72 recipients identified with no significant difference in graft survival between weight groups (5-y graft survival ~91%).
Higher primary nonfunction observed in the <15 kg group (12.5% vs 0.0%; P=0.03).
Kidney length and donor quality metrics (Kidney Donor Profile Index) favorably differed, supporting better outcomes for donors ≥15 kg.

Abstract

Background. Kidney transplantation (KTx) is superior to dialysis but is limited by organ shortages. Kidneys from pediatric donors, whether single or en bloc, have excellent outcomes but are underutilized, with little consensus on splitting pediatric en bloc grafts. Methods. A single-center retrospective review of all deceased donor KTx using single kidneys from pediatric donors weighing ≤20 kg between 2005 and 2023 was performed. Recipients were compared based on donor weight: 15 kg. However, single grafts from donors <15 kg carried a higher risk of primary nonfunction and should be approached with particular caution regarding donor quality and cold ischemia time.

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Outcomes of Single Pediatric Kidney Grafts: An Experienced Single-center Retrospective Study

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