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[Kidney transplantation in pediatric age.]

María José Martínez Urrutia1, Roberto Lobato Romera1, Susana Rivas Vila1

  • 1Servicio de Urología Pediátrica. Hospital Infantil La Paz. Madrid. España.

Archivos Espanoles De Urologia
|December 1, 2021
PubMed

Insights

Kidney transplantation (KT) offers better survival and quality of life for children with end-stage renal disease compared to dialysis. Ongoing research aims to improve long-term graft survival by reducing rejection and immunosuppression side effects.

Area of Science:

  • Pediatric Nephrology
  • Transplant Surgery
  • Immunology

Background:

  • Kidney transplantation (KT) is the optimal treatment for pediatric end-stage renal disease, surpassing dialysis in mortality and quality of life.
  • Broadened inclusion criteria reflect improvements, yet histocompatibility and donor source remain critical for graft longevity.
  • Pediatric KT presents unique challenges, including donor-recipient size discrepancies, growth impact, and adherence issues.

Purpose of the Study:

  • To review the current status and outcomes of kidney transplantation in children.
  • To identify key factors influencing graft survival and patient mortality.
  • To highlight areas for future research, focusing on immunological tolerance and reduced immunosuppression.

Main Methods:

  • Review of recent literature on pediatric kidney transplantation outcomes.
  • Analysis of factors affecting graft and patient survival, including donor type and rejection.
  • Examination of common causes of graft loss and mortality in the first post-transplant years.

Main Results:

  • Five-year graft survival rates are 90% for living donor KT and 70% for cadaveric donor KT.
  • Chronic rejection is the primary cause of graft loss.
  • Mortality within the first post-transplant years is below 6.5%, with infections and cardiovascular issues being leading causes of death.

Conclusions:

  • Pediatric kidney transplantation outcomes have significantly improved, approaching adult results.
  • Reducing immunosuppression and managing chronic rejection are crucial for enhancing long-term graft function.
  • Further research into achieving immunological tolerance is essential for improving pediatric KT success rates.

Keywords:
Ampliación vesicalBladder augmentationCadaveric donorDonante cadáverDonante vivoGraft survivalIliocava thrombosisLiving donorPediatric kidney transplantationSupervivencia del injertoTrasplante renal pediátricoTrombosis iliocava

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