Objective To investigate the clinical features of children's kidney transplantation, surgical method，postoperative immunosuppression and complications. Methods The clinical data of 40 cases of pediatric renal transplant patients in April 2003 to February 2017 were retrospectively analysed. There are 42 case-times kidney transplantations, thirty-one case-times were single kidney transplantations, of which 25 case-times were to anastomosis of the renal artery and the end of the internal iliac artery, and 6 case-times were to anastomosis of the renal artery and the recipient's external/temporal artery end ；In the double kidney transplantation, two case-times were separated double kidney transplantation, and 9 case-times were whole piece transplantation. Results A total of 40 children in the hospital completed 42 case-times kidney transplantations, two of which were re-transplanted. During the follow-up of 1 to 168 months, in these 40 recipients, single renal embolismt with isolated double kidney was in 2 cases ；perioperative pulmonary infection was in 4 cases , of which 2 were died, one was recovered dialysis and 1 were recovered after treatment ；delayed graft function（DGF）was in 4 cases ；acute rejection（AR）was in 4 cases ；urine leak was in 2 cases ；diabetes mellitus was in 1 case ；osteonecrosis of femoral head was in 1 case. The rest of the cases were well restored. The 1-year patient and graft survival rate was respectively 94.2 % and 91.2 %，respectively. Conclusion In spite of its high complications, pediatric renal transplantation is an effective treatment with its satisfactory one-year graft survival rate. Nevertheless, its long-term effect should be further observed.

目的 探讨儿童肾移植手术方式、术后免疫抑制方案、并发症等临床特点。方法 回顾性分 析 2003 年 4 月—2017 年 2 月中南大学湘雅二医院完成的 40 例儿童肾移植患者的临床资料。42 例次肾移植 手术中，31 例次为单肾移植，其中 25 例次将供肾动脉与受者的髂内动脉端端吻合，6 例次将供肾动脉与 受者的髂外 / 髂总动脉端端吻合 ；双肾移植中，2 例次为分离式双肾移植，9 例次为整块移植。结果 本院 共 40 例儿童患者完成肾移植 42 例次，其中 2 例为再次移植。术后随访 1 ～ 168 个月，2 例分离式双肾移 植患者出现单肾栓塞 ；4 例患者出现围手术期肺部感染，其中 2 例死亡，1 例恢复透析，1 例治疗后痊愈 ； 4 例患者出现移植肾功能延迟恢复 ；4 例急性排斥反应导致移植肾失功 ；2 例患者出现尿漏，1 例患者术后 4 年确诊为糖尿病 ；1 例出现股骨头缺血坏死 ；余例均恢复良好。1 年人、肾存活率分别为 94.2%、91.2%。 结论 虽然儿童肾移植并发症较多，但近期效果良好，远期效果仍有待进一步观察。