Current perspectives on kidney transplantation in low-weight pediatric patients. Review

Abstract

Kidney transplantation is the treatment of choice for children with end-stage renal disease, providing superior survival and quality of life compared to dialysis. However, transplantation in children with low body weight ( 20 kg) remains technically demanding and is associated with a higher risk of complications. These challenges are primarily related to donor–recipient size mismatch, limited anatomical space, and hemodynamic constraints. A narrative review of the literature was performed, focusing on surgical techniques, anatomical and hemodynamic factors, and early and late complications of kidney transplantation in low-weight pediatric recipients. Particular attention was given to the impact of size mismatch, the choice of surgical approach, and strategies for prevention and early detection of vascular complications.