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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...

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Related Experiment Video

Updated: Jun 21, 2026

Microdissection of Primary Renal Tissue Segments and Incorporation with Novel Scaffold-free Construct Technology
09:00

Microdissection of Primary Renal Tissue Segments and Incorporation with Novel Scaffold-free Construct Technology

Published on: March 27, 2018

Challenges in pediatric renal transplantation in developing countries.

S Adibul H Rizvi1, M Naqi Zafar, Ali A Lanewala

  • 1Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan.

Current Opinion in Organ Transplantation
|July 23, 2009
PubMed
Summary

Pediatric kidney transplants in developing nations primarily involve older children and living related donors. High rates of rejection and infection lead to poor graft and patient survival outcomes.

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Last Updated: Jun 21, 2026

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Area of Science:

  • Nephrology
  • Pediatric Surgery
  • Transplantation Medicine

Background:

  • Pediatric transplantation is a critical but under-resourced area in developing countries.
  • Limited data exists on the outcomes and challenges of pediatric transplants in these regions.

Purpose of the Study:

  • To review and synthesize findings from key reports on pediatric transplants in the developing world.
  • To identify and highlight the challenges and outcomes associated with pediatric transplantation in these settings.

Main Methods:

  • Systematic review of published literature on pediatric renal transplantation from developing countries.
  • Analysis of transplant activity, donor/recipient demographics, immunosuppression protocols, and survival rates.

Main Results:

  • Recent literature shows limited but ongoing pediatric renal transplant activity, with 11-300 transplants reported.
  • High acute rejection rates (over 40% in 50% of series) and significant infection-related morbidity and mortality were observed.
  • One-year graft survival ranged from 89-98%, and patient survival from 88-98%, with 5-year survival rates of 67-84% and 65-90%, respectively.

Conclusions:

  • Pediatric transplantation in developing countries predominantly uses living related donors for older children.
  • Challenges include high costs of immunosuppression leading to non-compliance, resulting in poor patient and graft survival due to rejection and infection.