End-stage renal disease (ESRD) is a rare but severe disease in childhood. In the recent era care for children with ESRD improved dramatically. Improved neonatal intensive care and opportunities for renal replacement therapy (RRT), including renal transplantation (Tx) for infants, resulted in increased survival rates.

Nevertheless, Tx in young children is challenging and requires expertise of a multidisciplinary medical team (surgeons, anaesthesiologists and paediatric nephrologists). Many centres accept a minimum recipient body weight of 10 kg, but sound evidence-based knowledge on a body weight cut-off is lacking.

Therefore, our main objectives are to evaluate:

(i) the current practice of Tx in young children in Europe;

(ii) the association between body weight at Tx with patient and graft survival and;

(iii) to define a minimum weight at Tx associated with an optimal outcome for young children.

Knowledge on outcome of paediatric renal transplantation in young children in relation to body weight could contribute to the development of clinical practice guidelines on Tx in this population.

Furthermore, our data could assist paediatric nephrologists to improve the management of this CKD subpopulation in paediatrics and could eventually lead to a lower use of dialysis, better patient and graft survival, and better health outcomes in European paediatric ESRD.