Cardiac adaptation in pediatric kidney transplant recipients with large donor-recipient size discrepancy: a speckle-tracking echocardiography study.

Mark W Schaars, Floris E A Udink Ten Cate, Elisabeth A M Cornelissen, Gert Weijers, Marieke Voet, Anne E C M Saris

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Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Mark W SchaarsTechnical Medicine, University of Twente, Enschede, The Netherlands.ORCID http://orcid.org/0009-0002-6730-5063

Floris E A Udink Ten CateDepartment of Pediatric Cardiology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands. Floris.UdinktenCate@radboudumc.nl.ORCID http://orcid.org/0000-0002-7889-5225

Elisabeth A M CornelissenDepartment of Pediatric Nephrology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-1156-5264

Gert WeijersMedical Ultrasound Imaging Centre, Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, the Netherlands.ORCID http://orcid.org/0000-0001-7125-2422

Marieke VoetDepartment of Anesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID http://orcid.org/0000-0003-3017-5410

Anne E C M SarisMedical Ultrasound Imaging Centre, Department of Medical Imaging, Radboud University Medical Centre, Nijmegen, the Netherlands.ORCID http://orcid.org/0000-0002-3402-3302

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6 · The paper itself

Abstract

backgroundPediatric living donor kidney transplantation (KT) with large donor-recipient size mismatch induces a large hemodynamic burden on the child recipient. Although successful KT is known to be beneficial for cardiac function and remodeling, its effects in small recipients with adult donors have not been evaluated. We aimed to describe left ventricular (LV) function and geometry using conventional and speckle-tracking echocardiography in this population.

methodsA prospective longitudinal study was performed. Living donor KT recipients with large donor-recipient size mismatch underwent conventional and speckle-tracking echocardiography prior to KT, shortly after KT and at 6 and 12 months post-transplantation. LV global longitudinal strain (GLS), LV ejection fraction, cardiac index, LV mass index (LVMi) and LV dimensions were obtained.

resultsTen patients were included with a median [IQR] age of 5.9 years [4.4-8.5]. The median donor-recipient body surface area ratio was 2.36. Prior to transplantation, LV systolic dysfunction was found in 80% of the patients (GLS -18.9% [-19.7--18.7]). Significant improvement was found after 12 months (change in GLS -1.3% [-1.8--0.9], p = 0.004). A significant reduction in LVMi was found at 6 months and 12 months of -8.9 g/m

conclusionsDespite the increased hemodynamic demands after pediatric KT with large donor-recipient size mismatch, improved LV function and reduced left ventricular mass were found within 1 year after transplantation. These results suggest reversed cardiac remodeling.

Indexed as

Kidney TransplantationLiving DonorsVentricular Dysfunction, LeftVentricular RemodelingAdaptation, PhysiologicalBody Surface AreaChildChild, PreschoolEchocardiographyFemaleGlobal Longitudinal StrainHeart VentriclesHumansLongitudinal StudiesMaleOrgan SizeDonor-recipient size mismatchGlobal longitudinal strainKidney transplantationPediatricSpeckle-tracking echocardiography

Identifiers

PMID42230385

DOI10.1007/s00467-026-07368-6

PMCPMC13612658

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