{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T21:29:00Z","timestamp":1788557340995,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T00:00:00Z","timestamp":1563753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Kidney transplantation remains the treatment of choice for children with ESRD. Optimal perioperative management is critical in small recipients of ASK to assure adequate graft perfusion. We present a single\u2010center experience outlining management for patients weighing &lt;20\u00a0kg who underwent primary renal transplantation with ASKs between 2007 and 2016. Sixty\u2010three patients met study criteria and underwent 34 living\u2010related, six living\u2010unrelated, and 23 deceased donor kidney transplants. Median age and weight at transplant were 25\u00a0months (IQR 18\u201037\u00a0months; range 11\u00a0months\u20106\u00a0years) and 11.0\u00a0kg (IQR 9.2\u201014.5\u00a0kg; range 7.1\u201019.5\u00a0kg). Eighty\u2010nine percent of patients required vasoactive agents intra\u2010operatively, with twenty patients requiring prolonged vasoactive agents post\u2010operatively. Intra\u2010operatively, patients received 51.9\u00a0mL\/kg of crystalloid, 27.3\u00a0mL\/kg of 5% albumin, and 13.6\u00a0mL\/kg of packed red blood cells. Most (93.7%) patients were extubated on POD#0. Weights peaked on post\u2010operative days three through five. Over a median follow\u2010up of 49\u00a0months (IQR 31\u201086\u00a0months; range 0\u2010130\u00a0months), four grafts were lost,\u00a0two due to thrombosis and two secondary to chronic rejection. There was one patient death six months post\u2010transplant due to causes unrelated to transplantation. Graft survival at 1, 5, and 10\u00a0years was 98.4%, 96.6%, and 84.2%, respectively. Of surviving allografts, the median 1, 5, and 10\u00a0years post\u2010transplant eGFR was 122.9, 90.0, and 59.2\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup> as determined by the 2009 Schwartz formula. Renal transplantation in small children using ASKs requires meticulous perioperative management including adequate fluid resuscitation and judicious use of pressors to assure adequate graft perfusion. The use of ASKs from living or deceased donors results in satisfactory short and long\u2010term outcomes.<\/jats:p>","DOI":"10.1111\/petr.13553","type":"journal-article","created":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T07:10:20Z","timestamp":1563779420000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Perioperative renal transplantation management in small children using adult\u2010sized living or deceased donor kidneys: A single\u2010center experience"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9680-5596","authenticated-orcid":false,"given":"Eliza","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Surgery Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Ramos-Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pediatric Transplant Center Boston Children\u2019s Hospital and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Staffa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Rodig","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Nephrology Boston Children\u2019s Hospital and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khashayar","family":"Vakili","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pediatric Transplant Center Boston Children\u2019s Hospital and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heung Bae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pediatric Transplant Center Boston Children\u2019s Hospital and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04920610"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004670000303"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000092524.75807.84"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.87.5.380"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1624-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0980"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000380828"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2195-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2007.00704.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13108"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1314376"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.9.1063"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200202150-00015"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-1959-3"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-2331"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31828a25fd"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200008150-00003"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199810150-00001"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.9.1035"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2006.03.007"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12947"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-018-3895-5"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001929"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000487195"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13116"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14557"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn667"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-015-3144-0"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpetr.13553","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13553","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.13553","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T02:02:59Z","timestamp":1752717779000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.13553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,22]]},"references-count":28,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/petr.13553"],"URL":"https:\/\/doi.org\/10.1111\/petr.13553","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,22]]},"assertion":[{"value":"2019-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13553"}}