{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:33:38Z","timestamp":1785346418979,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"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":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Kidney transplantation in small children is technically challenging. Consideration of whether to use intraperitoneal versus extraperitoneal placement of the graft depends on patient size, clinical history, anatomy, and surgical preference. We report a large single\u2010center experience of intraperitoneal kidney transplantation and their outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of pediatric patients who underwent kidney transplantation from April 2011 to March 2018 at a single large volume center. We identified those with intraperitoneal placement and assessed their outcomes, including graft and patient survival, rejection episodes, and surgical or non\u2010surgical complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six of 168 pediatric kidney transplants (27%) were placed intraperitoneally in children mean age 5.5\u00a0\u00b1\u00a02.3\u00a0years (range 1.6\u201310\u00a0years) with median body weight 18.2\u00a0\u00b1\u00a05\u00a0kg (range 11.4\u201328.6\u00a0kg) during the study period. Two patients (4%) had vascular complications; 10 (22%) had urologic complications requiring intervention; all retained graft function. Thirteen patients (28%) had prolonged post\u2010operative ileus. Eight (17%) patients had rejection episodes \u22646\u00a0months post\u2010transplant. Only one case resulted in graft loss and was associated with recurrent focal segmental glomerular sclerosis (FSGS). Two patients (4%) had chronic rejection and subsequent graft loss by 5\u2010year follow\u2010up. At 7\u2010year follow\u2010up, graft survival was 93% and patient survival was 98%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The intraperitoneal approach offers access to the great vessels, which allows greater inflow and outflow and more abdominal capacity for an adult donor kidney, which is beneficial in very small patients. Risk of graft failure and surgical complications were not increased when compared to other published data on pediatric kidney transplants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14294","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T07:30:36Z","timestamp":1650958236000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Good outcomes after pediatric intraperitoneal kidney transplant"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5368-6929","authenticated-orcid":false,"given":"Elizabeth A.","family":"Gerzina","sequence":"first","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-5986","authenticated-orcid":false,"given":"Eileen D.","family":"Brewer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Renal Section Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6960-5978","authenticated-orcid":false,"given":"Maya","family":"Guhan","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0916-3589","authenticated-orcid":false,"given":"Joseph D.","family":"Geha","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation Michael E. DeBakey Department of Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh P.","family":"Huynh","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"O\u2019Conor","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Thorsen","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail C.","family":"Tan","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirti","family":"Bhakta","sequence":"additional","affiliation":[{"name":"Transplant Services Texas Children\u2019s Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kat","family":"Hosek","sequence":"additional","affiliation":[{"name":"Outcomes and Impact Service Texas Children\u2019s Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2795-0527","authenticated-orcid":false,"given":"Tahir H.","family":"Malik","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine A.","family":"O\u2019Mahony","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplantation Michael E. 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