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Establishing an animal model that can simulate clinical pediatric\u2010to\u2010adult (P\u2192A) kidney transplantation is important for studying the characteristics and potential mechanisms related to this rapid graft growth. In the P\u2192A group, kidneys harvested from 3\u2010 to 4\u2010week\u2010old Sprague\u2013Dawley (SD) rats weighing &lt;50\u2009g were transplanted into adult SD rats (300\u2010400\u2009g). Novel techniques were employed using recipient common iliac vessels for vascular anastomosis and ureter graft drag\u2010in connection to the recipient bladder. As a control group, conventional kidney transplantation was performed between adult SD rats (A\u2192A group). A total of 11 transplants were performed in the P\u2192A group. Eight recipients survived to 28\u2009days without obvious complications and were euthanized for graft harvesting and analysis. Ultrasonography showed that the renal grafts grew significantly faster in the P\u2192A group than in the A\u2192A group during the first 7\u2009days after transplantation, and the size of the renal grafts in the two groups was similar on day 28. Histology revealed significant glomerular enlargement and cell proliferation in the pediatric donor kidneys, with signs of hyperfiltration injury but without podocyte proliferation. Proximal tubular epithelial cells (PTECs) in the P\u2192A group showed significant cell proliferation and hypertrophy. This study has successfully established an animal model in rats with similar characteristics to clinical P\u2192A kidney transplantation, providing a new tool for studying the pathophysiological changes and potential mechanisms of early rapid compensatory growth of the grafts after small pediatric donor kidneys were transplanted into size\u2010mismatched large adult recipients.<\/jats:p>","DOI":"10.1096\/fj.202402958r","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T07:38:21Z","timestamp":1742369901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Establishment of a rat model of pediatric\u2010to\u2010adult kidney transplantation to study the early rapid compensatory growth of the grafts"],"prefix":"10.1096","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4985-6036","authenticated-orcid":false,"given":"Tianhui","family":"Pan","sequence":"first","affiliation":[{"name":"Institution of Organ Transplantation, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3559-1332","authenticated-orcid":false,"given":"Junbo","family":"Li","sequence":"additional","affiliation":[{"name":"Institution of Organ Transplantation, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4752-4939","authenticated-orcid":false,"given":"Lan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Institution of Organ Transplantation, Tongji Hospital, Tongji Medical College Huazhong 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