In our center we experienced a high risk of primary nonfunction with low weight recipients (
Three things are critical on the recipients side(aside of donor related issues e.g. CIT and qualtiy of the graft): 1. volume load, i.e. CVP around 10 mm mercury and 2. systolic blood pressure > 100 mm mercury, 3. WIT during anastomsis (should not exceed 30 min) to reperfusion. I would suggest you do an analysis of your procedure and identify potential weaknesses.
Post operative fluid management to keep cvp above 10-12 mm mercury is very important.
We also keep blood pressure high close to donor range first few post operative days.
Surgical technique end to side anastamosis and reperfusion time is improtant
We also use lasix drip first couple of post operative days specially in oliguric patients
Our center had no thrombosis of the renal graft in young children last 25 years
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