Effect of Donor-recipient Size on Graft Growth in Pediatric Donor-to-pediatric Recipient Kidney Transplantation

Background: Kidney transplantation is the optimal treatment for pediatric end-stage kidney disease, yet donor shortages have driven the use of pediatric donor kidneys through pediatric donor-to-pediatric recipient (PTP) kidney transplantation. This study aimed to investigate the effect of donor-recipient size on graft growth in PTP kidney transplantation. Methods: This retrospective cohort study included kidney transplant recipients who underwent regular follow-ups between January 2016 and December 2023 at the Children's Hospital of Fudan University. All donors were deceased and aged <18 y. Dynamic clinical data were obtained from medical records spanning the pretransplant to posttransplant period. Results: < 0.01). Smaller grafts required approximately 6 mo to reach a normative size consistent with the recipients' age. Conclusions: Grafts showed stable growth patterns and favorable short-term follow-up outcomes. Additionally, PTP kidney transplantation demonstrated both clinical value and practical utility.