{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:56:14Z","timestamp":1793912174947,"version":"4.8.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Children with end-stage renal disease (ESRD) frequently require more than one kidney transplantation (KT) during their lifetime due to limited graft longevity. Despite this clinical reality, few studies have evaluated long-term outcomes following repeat pediatric KT. We conducted a retrospective single-center study analyzing 120 KTs performed in 89 pediatric recipients between 1993 and 2024. Outcomes included graft function, postoperative complications, and long-term graft and patient survival. Recipients were stratified into primary (1KT), second (2KT), and third (3KT) transplantation groups. At the time of 1KT, median recipient age was 11.0\u00a0years (IQR 7.0, 14.5). Living donation accounted for 16.7% of procedures. Graft failure within five years occurred in approximately 20% of 1KT cases. Half of these patients received a 2KT after a median waiting time of 4.6\u00a0years (IQR 2.1, 9.0). Rates of early postoperative complications and kidney function were comparable across groups. Kaplan\u2013Meier analysis revealed significantly improved long-term survival following 2KT compared to failed 1KT (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.023). Repeat kidney transplantation is a feasible and effective strategy for pediatric ESRD patients. Second transplants provide long-term outcomes comparable to, or better than, initial grafts. Multicenter prospective studies are warranted to confirm these findings.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-28562-w","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T07:14:51Z","timestamp":1764227691000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of pediatric kidney re-transplantation: a single-center cohort study"],"prefix":"10.1038","volume":"15","author":[{"given":"Franziska","family":"Meyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Michael","family":"Tautenhahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Seiffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kowald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Putz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Jonas","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svitlana","family":"Ziganshyna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katalin","family":"Dittrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Seehofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Scheuermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"issue":"3","key":"28562_CR1","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s00467-011-1939-1","volume":"27","author":"J Harambat","year":"2012","unstructured":"Harambat, J., van Stralen, K. J., Kim, J. J. & Tizard, E. J. Epidemiology of chronic kidney disease in children. Pediatr. Nephrol. 27(3), 363\u2013373. https:\/\/doi.org\/10.1007\/s00467-011-1939-1 (2012).","journal-title":"Pediatr. Nephrol."},{"issue":"6","key":"28562_CR2","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1053\/j.ackd.2017.09.009","volume":"24","author":"SA Hebert","year":"2017","unstructured":"Hebert, S. A., Swinford, R. D., Hall, D. R., Au, J. K. & Bynon, J. S. Special considerations in pediatric kidney transplantation. Adv. Chronic Kidney Dis. 24(6), 398\u2013404. https:\/\/doi.org\/10.1053\/j.ackd.2017.09.009 (2017).","journal-title":"Adv. Chronic Kidney Dis."},{"issue":"3","key":"28562_CR3","doi-asserted-by":"publisher","first-page":"151194","DOI":"10.1016\/j.sempedsurg.2022.151194","volume":"31","author":"CP Lemoine","year":"2022","unstructured":"Lemoine, C. P., Pozo, M. E. & Superina, R. A. Overview of pediatric kidney transplantation. Semin. Pediatr. Surg. 31(3), 151194. https:\/\/doi.org\/10.1016\/j.sempedsurg.2022.151194 (2022).","journal-title":"Semin. Pediatr. Surg."},{"issue":"2","key":"28562_CR4","doi-asserted-by":"publisher","first-page":"296","DOI":"10.2215\/CJN.16891020","volume":"17","author":"HE Fernandez","year":"2022","unstructured":"Fernandez, H. E. & Foster, B. J. Long-term care of the pediatric kidney transplant recipient. Clin. J. Am. Soc. Nephrol. 17(2), 296\u2013304. https:\/\/doi.org\/10.2215\/CJN.16891020 (2022).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"issue":"26","key":"28562_CR5","doi-asserted-by":"publisher","first-page":"2654","DOI":"10.1056\/NEJMoa031643","volume":"350","author":"SP McDonald","year":"2004","unstructured":"McDonald, S. P., Craig, J. C., Australian and New Zealand Paediatric Nephrology Association. Long-term survival of children with end-stage renal disease. N. Engl. J. Med. 350(26), 2654\u20132662. https:\/\/doi.org\/10.1056\/NEJMoa031643 (2004).","journal-title":"N. Engl. J. Med."},{"issue":"1","key":"28562_CR6","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2215\/CJN.02180314","volume":"10","author":"D Franke","year":"2015","unstructured":"Franke, D. et al. Patterns of growth after kidney transplantation among children with ESRD. Clin. J. Am. Soc. Nephrol. 10(1), 127\u2013134. https:\/\/doi.org\/10.2215\/CJN.02180314 (2015).","journal-title":"Clin. J. Am. Soc. Nephrol."},{"issue":"7","key":"28562_CR7","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.1007\/s00467-021-04922-2","volume":"36","author":"J Grohs","year":"2021","unstructured":"Grohs, J. et al. Determinants of growth after kidney transplantation in prepubertal children. Pediatr. Nephrol. 36(7), 1871\u20131880. https:\/\/doi.org\/10.1007\/s00467-021-04922-2 (2021).","journal-title":"Pediatr. Nephrol."},{"issue":"2","key":"28562_CR8","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1111\/petr.12034","volume":"17","author":"JM Smith","year":"2013","unstructured":"Smith, J. M., Martz, K. & Blydt-Hansen, T. D. Pediatric kidney transplant practice patterns and outcome benchmarks, 1987\u20132010: A report of the North American Pediatric Renal Trials and Collaborative Studies. Pediatr. Transplant 17(2), 149\u2013157. https:\/\/doi.org\/10.1111\/petr.12034 (2013).","journal-title":"Pediatr. Transplant"},{"issue":"1","key":"28562_CR9","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.pcl.2018.09.008","volume":"66","author":"PD Winterberg","year":"2019","unstructured":"Winterberg, P. D. & Garro, R. Long-term outcomes of kidney transplantation in children. Pediatr. Clin. North Am. 66(1), 269\u2013280. https:\/\/doi.org\/10.1016\/j.pcl.2018.09.008 (2019).","journal-title":"Pediatr. Clin. North Am."},{"issue":"2 Suppl 1","key":"28562_CR10","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1016\/j.ajt.2023.02.004","volume":"23","author":"KL Lentine","year":"2023","unstructured":"Lentine, K. L. et al. OPTN\/SRTR 2021 annual data report: Kidney. Am. J. Transplant. 23(2 Suppl 1), S21\u2013S120. https:\/\/doi.org\/10.1016\/j.ajt.2023.02.004 (2023).","journal-title":"Am. J. Transplant."},{"issue":"11","key":"28562_CR11","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1097\/TP.0b013e31828c6d64","volume":"95","author":"KJ Van Arendonk","year":"2013","unstructured":"Van Arendonk, K. J. et al. Practice patterns and outcomes in retransplantation among pediatric kidney transplant recipients. Transplantation 95(11), 1360\u20131368. https:\/\/doi.org\/10.1097\/TP.0b013e31828c6d64 (2013).","journal-title":"Transplantation"},{"issue":"2","key":"28562_CR12","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s00467-019-04362-z","volume":"36","author":"J Chandar","year":"2021","unstructured":"Chandar, J., Chen, L., Defreitas, M., Ciancio, G. & Burke, G. 3rd. Donor considerations in pediatric kidney transplantation. Pediatr. Nephrol. 36(2), 245\u2013257. https:\/\/doi.org\/10.1007\/s00467-019-04362-z (2021).","journal-title":"Pediatr. Nephrol."},{"issue":"2","key":"28562_CR13","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1097\/MOP.0000000000000740","volume":"31","author":"VK Sigurjonsdottir","year":"2019","unstructured":"Sigurjonsdottir, V. K. & Grimm, P. C. Living or deceased donor kidney transplantation in children. Curr. Opin. Pediatr. 31(2), 232\u2013236. https:\/\/doi.org\/10.1097\/MOP.0000000000000740 (2019).","journal-title":"Curr. Opin. Pediatr."},{"issue":"5","key":"28562_CR14","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1097\/TP.0b013e31829acb10","volume":"96","author":"KJ Arendonk","year":"2013","unstructured":"Arendonk, K. J. et al. Order of donor type in pediatric kidney transplant recipients requiring retransplantation. Transplantation 96(5), 487\u2013493. https:\/\/doi.org\/10.1097\/TP.0b013e31829acb10 (2013).","journal-title":"Transplantation"},{"issue":"2","key":"28562_CR15","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1097\/TP.0000000000000588","volume":"99","author":"KJ Van Arendonk","year":"2015","unstructured":"Van Arendonk, K. J. et al. Choosing the order of deceased donor and living donor kidney transplantation in pediatric recipients: A Markov decision process model. Transplantation 99(2), 360\u2013366. https:\/\/doi.org\/10.1097\/TP.0000000000000588 (2015).","journal-title":"Transplantation"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28562-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28562-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28562-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T09:14:26Z","timestamp":1764321266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-28562-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,27]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["28562"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-28562-w","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,27]]},"assertion":[{"value":"28 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was approved by the local ethics committee of the University of Leipzig (approval number EK: 111\/16\/14032016). Written informed consent was obtained for data collection in a prospectively maintained database. The need for additional consent for this retrospective analysis was waived in accordance with local regulations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"42557"}}