Surgical considerations in paediatric kidney transplantation: an update
Abstract Background Kidney transplantation has established itself as the most appropriate mode of renal replacement therapy for the majority with end-stage kidney disease. Although at present this is applicable for children as well as adults, a few decades back kidney transplantation was not conside...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Renal Replacement Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41100-021-00373-5 |
| _version_ | 1818425643016126464 |
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| author | Thilina Gunawardena Hemant Sharma Ajay Kumar Sharma Sanjay Mehra |
| author_facet | Thilina Gunawardena Hemant Sharma Ajay Kumar Sharma Sanjay Mehra |
| author_sort | Thilina Gunawardena |
| collection | DOAJ |
| description | Abstract Background Kidney transplantation has established itself as the most appropriate mode of renal replacement therapy for the majority with end-stage kidney disease. Although at present this is applicable for children as well as adults, a few decades back kidney transplantation was not considered a first-line option in children. This was due to inferior outcomes following transplantation in this age group compared to that of adults. These poor results were attributed to challenges in paediatric transplantation such as the shortage of suitable donors, technical difficulties in performing a sound vascular anastomosis and the adverse effects of immunosuppressive medication on growth and development. However, current patient and graft-centred outcomes after paediatric transplantation equal or surpass that of adults. The advances in evaluation and management of specific surgical concerns in children who undergo transplantation, such as pre-transplant native nephrectomy, correction of congenital anomalies of the urinary tract, placement of an adult-sized kidney in a small child and minimizing the risk of allograft thrombosis, have contributed immensely for these remarkable outcomes. Conclusions In this review, we aim to discuss surgical factors that can be considered unique for children undergoing kidney transplantation. We believe that an updated knowledge on these issues will be invaluable for transplant clinicians, who are dealing with paediatric kidney transplantation. |
| first_indexed | 2024-12-14T14:17:12Z |
| format | Article |
| id | doaj.art-31394daadc90486f9418add815a7ca93 |
| institution | Directory Open Access Journal |
| issn | 2059-1381 |
| language | English |
| last_indexed | 2024-12-14T14:17:12Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Renal Replacement Therapy |
| spelling | doaj.art-31394daadc90486f9418add815a7ca932022-12-21T22:58:10ZengBMCRenal Replacement Therapy2059-13812021-10-01711610.1186/s41100-021-00373-5Surgical considerations in paediatric kidney transplantation: an updateThilina Gunawardena0Hemant Sharma1Ajay Kumar Sharma2Sanjay Mehra3Sir Peter Medawar Unit, Royal Liverpool University HospitalSir Peter Medawar Unit, Royal Liverpool University HospitalSir Peter Medawar Unit, Royal Liverpool University HospitalSir Peter Medawar Unit, Royal Liverpool University HospitalAbstract Background Kidney transplantation has established itself as the most appropriate mode of renal replacement therapy for the majority with end-stage kidney disease. Although at present this is applicable for children as well as adults, a few decades back kidney transplantation was not considered a first-line option in children. This was due to inferior outcomes following transplantation in this age group compared to that of adults. These poor results were attributed to challenges in paediatric transplantation such as the shortage of suitable donors, technical difficulties in performing a sound vascular anastomosis and the adverse effects of immunosuppressive medication on growth and development. However, current patient and graft-centred outcomes after paediatric transplantation equal or surpass that of adults. The advances in evaluation and management of specific surgical concerns in children who undergo transplantation, such as pre-transplant native nephrectomy, correction of congenital anomalies of the urinary tract, placement of an adult-sized kidney in a small child and minimizing the risk of allograft thrombosis, have contributed immensely for these remarkable outcomes. Conclusions In this review, we aim to discuss surgical factors that can be considered unique for children undergoing kidney transplantation. We believe that an updated knowledge on these issues will be invaluable for transplant clinicians, who are dealing with paediatric kidney transplantation.https://doi.org/10.1186/s41100-021-00373-5Paediatric kidney transplantCAKUTSurgical issues |
| spellingShingle | Thilina Gunawardena Hemant Sharma Ajay Kumar Sharma Sanjay Mehra Surgical considerations in paediatric kidney transplantation: an update Renal Replacement Therapy Paediatric kidney transplant CAKUT Surgical issues |
| title | Surgical considerations in paediatric kidney transplantation: an update |
| title_full | Surgical considerations in paediatric kidney transplantation: an update |
| title_fullStr | Surgical considerations in paediatric kidney transplantation: an update |
| title_full_unstemmed | Surgical considerations in paediatric kidney transplantation: an update |
| title_short | Surgical considerations in paediatric kidney transplantation: an update |
| title_sort | surgical considerations in paediatric kidney transplantation an update |
| topic | Paediatric kidney transplant CAKUT Surgical issues |
| url | https://doi.org/10.1186/s41100-021-00373-5 |
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