Pediatric kidney transplantation: a review
Amit Sharma, Rajesh Ramanathan, Marc Posner, Robert A Fisher Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA Abstract: Pediatric kidney transplantation is the preferred treatment for children with end-stage renal disease. The most common indications for transplantatio...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2013-07-01
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| Series: | Transplant Research and Risk Management |
| Online Access: | http://www.dovepress.com/pediatric-kidney-transplantation-a-review-a13676 |
| _version_ | 1818580448059588608 |
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| author | Sharma A Ramanathan R Posner M Fisher RA |
| author_facet | Sharma A Ramanathan R Posner M Fisher RA |
| author_sort | Sharma A |
| collection | DOAJ |
| description | Amit Sharma, Rajesh Ramanathan, Marc Posner, Robert A Fisher Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA Abstract: Pediatric kidney transplantation is the preferred treatment for children with end-stage renal disease. The most common indications for transplantation in children are renal developmental anomalies, obstructive uropathy, and focal segmental glomerulosclerosis. Living donor kidney transplants are often performed pre-emptively and offer excellent graft function. Policy changes in deceased-donor kidney allocation have increased the proportion of such transplants in pediatric recipients. Adequate pretransplant workup along with evaluation of urologic abnormalities is imperative in achieving good outcomes. Overall, patient and graft outcomes after kidney transplantation have improved, with five-year deceased donor and living donor graft survivals of 78.8% and 84.3%, respectively. Improvements in induction and maintenance immunosuppression have contributed to the gradual improvement in outcomes. Unique challenges in pediatric recipients include increased graft thrombosis, adverse growth, and abnormal development relating to immunosuppression, increased rejection due to nonadherence, increased susceptibility to opportunistic infections, and post-transplant malignancy. This review focuses on the current practices and outcomes in pediatric kidney transplantation in North America. We discuss the indications for transplantation, the evaluation process, some key surgical and immunologic considerations, and the common risk factors for graft dysfunction. Keywords: pediatric kidney transplantation, end-stage renal disease, dialysis, organ donors, immunosuppression |
| first_indexed | 2024-12-16T07:17:45Z |
| format | Article |
| id | doaj.art-c4541a5992ac4d31a8c9f278c7f19f01 |
| institution | Directory Open Access Journal |
| issn | 1179-1616 |
| language | English |
| last_indexed | 2024-12-16T07:17:45Z |
| publishDate | 2013-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Transplant Research and Risk Management |
| spelling | doaj.art-c4541a5992ac4d31a8c9f278c7f19f012022-12-21T22:39:44ZengDove Medical PressTransplant Research and Risk Management1179-16162013-07-012013default2131Pediatric kidney transplantation: a reviewSharma ARamanathan RPosner MFisher RAAmit Sharma, Rajesh Ramanathan, Marc Posner, Robert A Fisher Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA Abstract: Pediatric kidney transplantation is the preferred treatment for children with end-stage renal disease. The most common indications for transplantation in children are renal developmental anomalies, obstructive uropathy, and focal segmental glomerulosclerosis. Living donor kidney transplants are often performed pre-emptively and offer excellent graft function. Policy changes in deceased-donor kidney allocation have increased the proportion of such transplants in pediatric recipients. Adequate pretransplant workup along with evaluation of urologic abnormalities is imperative in achieving good outcomes. Overall, patient and graft outcomes after kidney transplantation have improved, with five-year deceased donor and living donor graft survivals of 78.8% and 84.3%, respectively. Improvements in induction and maintenance immunosuppression have contributed to the gradual improvement in outcomes. Unique challenges in pediatric recipients include increased graft thrombosis, adverse growth, and abnormal development relating to immunosuppression, increased rejection due to nonadherence, increased susceptibility to opportunistic infections, and post-transplant malignancy. This review focuses on the current practices and outcomes in pediatric kidney transplantation in North America. We discuss the indications for transplantation, the evaluation process, some key surgical and immunologic considerations, and the common risk factors for graft dysfunction. Keywords: pediatric kidney transplantation, end-stage renal disease, dialysis, organ donors, immunosuppressionhttp://www.dovepress.com/pediatric-kidney-transplantation-a-review-a13676 |
| spellingShingle | Sharma A Ramanathan R Posner M Fisher RA Pediatric kidney transplantation: a review Transplant Research and Risk Management |
| title | Pediatric kidney transplantation: a review |
| title_full | Pediatric kidney transplantation: a review |
| title_fullStr | Pediatric kidney transplantation: a review |
| title_full_unstemmed | Pediatric kidney transplantation: a review |
| title_short | Pediatric kidney transplantation: a review |
| title_sort | pediatric kidney transplantation a review |
| url | http://www.dovepress.com/pediatric-kidney-transplantation-a-review-a13676 |
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