Introduction Vascular complications are severe complications of pediatric kidney transplantation (KT). We aimed to investigate whether a complex bench surgery (BS) affects the outcomes.

Methods All pediatric KT performed at the University Hospital of Padua from 2015 to 2019 were analyzed, comparing those in which a standard BS was possible to those that necessitated a complex BS. The rates of vascular complications, patients' outcome, and graft survival were compared in the two groups.

Results Eighty KTs were performed in 78 patients with a median age of 11 years (interquartile range [IQR] 4.3–14) and a median body weight of 24 kg (IQR 13–37). Thirty-nine donor kidneys (49%) needed a complex BS due to anomalies of renal veins in 12 (31%) and renal arteries in 16 (41%). The remaining 11 grafts (28%) underwent an elongation of the vein. There was no difference in the rate of primary graft non function (p = 0.97), delayed graft function (p = 0.72), and overall survival (p = 0.27). The rates of vascular complications, bleedings, and venous graft thrombosis were similar (p = 0.51, p = 0.59, p = 0.78, respectively). No arterial thrombosis or stenosis was reported.

Conclusion Complex BS did not compromise survival of the graft and did not put the allograft at risk of vascular complications, such as bleedings or thrombosis.

引言 血管并发症是小儿肾移植 (KT) 的严重并发症。我们的目的是调查复杂的卧推手术 (BS) 是否会影响结果。

方法 对 2015 年至 2019 年在帕多瓦大学医院进行的所有儿科 KT 进行了分析，比较了可能需要标准 BS 的那些和需要复杂 BS 的那些。比较两组的血管并发症发生率、患者预后和移植物存活率。

结果 78 名中位年龄为 11 岁（四分位间距 [IQR] 4.3-14）且中位体重为 24 kg（IQR 13-37）的患者进行了 80 次 KT。由于 12 个 (31%) 肾静脉异常和 16 个 (41%) 肾动脉异常，39 个供体肾脏 (49%) 需要复杂的 BS。其余 11 个移植物 (28%) 经历了静脉延长。初次移植物无功能 ( p  = 0.97)、延迟移植物功能 ( p  = 0.72) 和总生存率 ( p = 0.27)没有差异 。血管并发症、出血和静脉移植物血栓形成的发生率相似 ( p  = 0.51，p  = 0.59，p = 0.78，分别）。没有动脉血栓形成或狭窄的报道。

结论 复合 BS 不会影响移植物的存活，并且不会使同种异体移植物面临血管并发症的风险，例如出血或血栓形成。