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Renal transplantation.

¹George Washington University, 3.5-300, West Wing, Department of Nephrology, Children's National Medical Center, Washington, D.C. 20010, USA. amoudgil@cnmc.org

Indian Journal of Pediatrics

|June 6, 2003

Summary

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Pediatric renal transplantation significantly enhances quality of life for children with end-stage renal disease. Advances in immunosuppression and surgical techniques improve graft survival, but careful pre-transplant evaluation is crucial.

Area of Science:

Pediatric Nephrology
Transplantation Immunology
Surgical Innovation

Background:

End-stage renal disease (ESRD) in children necessitates renal replacement therapy.
Renal transplantation is the optimal therapy, improving growth, neurodevelopment, and quality of life.
Significant advancements have improved patient and graft survival rates.

Purpose of the Study:

To review the current state of pediatric renal transplantation.
To highlight key advancements and challenges in the field.
To emphasize the importance of comprehensive management protocols.

Main Methods:

Review of current literature on pediatric renal transplantation.
Discussion of essential pre-transplant criteria and post-transplant management.

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Analysis of common immunosuppressive regimens and potential complications.

Main Results:

Successful transplantation requires compatible blood groups and negative crossmatch.
Common immunosuppressants include cyclosporine A/tacrolimus, azathioprine/mycophenolate mofetil, and prednisone.
Key complications include acute rejection, infections, hypertension, and disease recurrence.

Conclusions:

Pediatric renal transplantation offers superior outcomes for ESRD.
Standardized protocols for evaluation, immunosuppression, and infection prevention are essential.
Socio-economic factors and preemptive living-donor transplantation warrant consideration, especially in developing countries.