Clinical Outcomes and Complications after Pediatric Kidney Transplantation: A Single-Centre Retrospective Cohort
Saahiti Sunkara, Swarnalatha G*, Prashant Kumar Dixit, Snigdha Bachalakuri and Vijay Chander Bukka
ABSTRACT
Background: Contemporary outcome data from pediatric kidney transplant programmed in resource-constrained settings remain limited. We described recipient characteristics, post-transplant complications, and status at last follow-up in a single-centre cohort.
Methods: We performed a retrospective study of 50 kidney transplant recipients aged 18 years or younger at transplantation between 2011 and 2025. Clinical variables were analyzed descriptively. Continuous variables were summarized as mean and standard deviation, and categorical variables as frequency and percentage.
Results: Recipients aged 11–14 years comprised 14 (28%) and those aged 15–18 years 36 (72%); 37 (74%) were male. Donors were mothers in 30 (60%), fathers in 14 (28%), and deceased donors in 6 (12%). Induction was not given in 31 (62%), while 12 (24%) received basiliximab and 7 (14%) antithymocyte globulin. Among the 31 recipients without induction, 23 (74.2%) had rejection: chronic antibody-mediated rejection in 11 (35.48%), acute antibody-mediated rejection in 6 (19.4%), and acute cellular rejection in 6 (19.4%). Calcineurin-inhibitor toxicity occurred in 26%, rejection in 46%, recurrence in 10%, cytomegalovirus infection in 12%, and post-transplant diabetes mellitus in 20%. At last follow-up, 34 (68%) recipients were alive, 10 (20%) were alive with a failing graft, and 6 (12%) had died.
Conclusion: Post-transplant complications were frequent in this pediatric cohort. The findings emphasize the higher rejection burden observed among recipients without induction and the importance of careful calcineurin-inhibitor monitoring to reduce toxicity and infection.
