Technical Aspects of Kidney Transplant and Salvage Procedures for Technical Complications in the Child

  • Heron D. Baumgarten
  • Sara K. Rasmussen
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Kidney transplantation is a lifesaving therapy for children with end-stage renal disease. Several important factors impact the technical aspect of the procedure for children. Their blood vessels are smaller in caliber, making technique an even more critical part of a successful transplant procedure. Discrepancies between the size of the donor kidney, which often comes from an adult, into a small pediatric recipient can necessitate substantial modifications to the procedure. Additionally, children with obstructive uropathies can have smaller bladders and conduits, making ureteral implantation more challenging. Despite all of these aspects, renal transplantation is a lifesaving operation that allows children with end-stage renal disease to live a higher-quality life than they could expect with dialysis. These patients can be hopeful of graft function in excess of 20 years.


Anastomosis Children Extraperitoneal Growth failure Kidney transplant Lymphocele Nephroureterectomy Neurogenic bladders Obstructive uropathy Peritoneal dialysis Renal replacement therapy Transplant renal artery stenosis Ureteral implantation Ureteroneocystostomy Ureteroureterostomy Renal vein thrombosis Renal artery thrombosis Bladder augmentation Vascular reconstruction 


  1. Barr J, Brayman KL (2015) Development and evolution of self-retaining retractors in surgery: the example of the Bookwalter retractor. J Am Coll Surg 221(2):628–634CrossRefPubMedGoogle Scholar
  2. Corbetta JP, Weller S, Bortagaray JI et al (2012) Ureteral replacement with appendix in pediatric renal transplantation. Pediatr Transplant 16(3):235–238CrossRefPubMedGoogle Scholar
  3. DeFoor W, Tackett L, Minevich E et al (2003) Successful renal transplantation in children with posterior urethral valves. J Urol 170(6 Pt 1):2402–2404CrossRefPubMedGoogle Scholar
  4. Dinckan A, Aliosmanoglu I, Adman S et al (2015) Renal transplantation with size-matched end-to-end venous anastomosis in children with inferior vena cava thrombosis. Transplant Proc 47(5):1345–1347CrossRefPubMedGoogle Scholar
  5. Ferraresso M, Ghio L, Raiteri M et al (2008) Pediatric kidney transplantation: a snapshot 10 years later. Transplant Proc 40(6):1852–1853CrossRefPubMedGoogle Scholar
  6. Giessing M, Muller D, Winkelmann B et al (2007) Kidney transplantation in children and adolescents. Transplant Proc 39(7):2197–2201CrossRefPubMedGoogle Scholar
  7. Giuliani S, Gamba P, Kiblawi R et al (2014) Lymphocele after pediatric kidney transplantation: incidence and risk factors. Pediatr Transplant 18(7):720–725CrossRefPubMedGoogle Scholar
  8. Irtan S, Maisin A, Baudouin V et al (2010) Renal transplantation in children: critical analysis of age related surgical complications. Pediatr Transplant 14(4):512–519CrossRefPubMedGoogle Scholar
  9. Kumar S, Rathore Y, Guleria S et al (2014) Renal transplantation in a child with thrombosed inferior vena cava. Saudi J Kidney Dis Transpl 25(2):367–369CrossRefPubMedGoogle Scholar
  10. Mickelson JJ, MacNeily AE, Leblanc J et al (2006) Renal transplantation in children 15 kg or less: the British Columbia Children’s Hospital experience. J Urol 176(4 Pt 2):1797–1800CrossRefPubMedGoogle Scholar
  11. Routh JC, Yu RN, Kozinn SI et al (2013) Urological complications and vesicoureteral reflux following pediatric kidney transplantation. J Urol 189(3):1071–1076CrossRefPubMedGoogle Scholar
  12. Salvatierra O Jr, Millan M, Concepcion W (2006) Pediatric renal transplantation with considerations for successful outcomes. Semin Pediatr Surg 15(3):208–217CrossRefPubMedGoogle Scholar
  13. Salvatierra O Jr, Concepcion W, Sarwal MM (2008) Renal transplantation in children with thrombosis of the inferior vena cava requires careful assessment and planning. Pediatr Nephrol 23(12):2107–2109CrossRefPubMedGoogle Scholar
  14. Tanabe K, Takahashi K, Kawaguchi H et al (1998) Surgical complications of pediatric kidney transplantation: a single center experience with the extraperitoneal technique. J Urol 160(3 Pt 2):1212–1215PubMedGoogle Scholar
  15. Torricelli FCM, Watanabe A, Piovesan AC et al (2015) Urological complications, vesicoureteral reflux, and long-term graft survival rate after pediatric kidney transplantation. Pediatr Transplant 19(8):844–848CrossRefPubMedGoogle Scholar
  16. Van Arendonk KJ, Goldstein SD, Salazar JH et al (2015) A nipple-valve technique for ureteroneocystostomy in pediatric kidney transplantation. Pediatr Transplant 19(1):42–47CrossRefPubMedGoogle Scholar
  17. Yamazaki Y, Tanabe K, Ota T et al (1998) Renal transplantation into augmented bladders. Int J Urol 5(5):423–427CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Virginia School of MedicineCharlottesvilleUSA

Section editors and affiliations

  • Bruce Kaiser
    • 1
  1. 1.Division of Solid Organ Transplantation, EmeritusAlfred I. duPont Hospital for ChildrenWilmingtonUSA

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