Related Experiment Video
Updated: Aug 8, 2026
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Progress in renal transplantation for children
1Division of Nephrology, Children's Hospital and Medical Center, University of Washington, Seattle 98105, USA.
Insights
Pediatric renal transplantation aims to treat end-stage renal disease, considering various patient factors. While outcomes improve, pediatric transplant results still trail those of young adults, highlighting ongoing challenges in pediatric kidney transplant care.
Area of Science:
- Nephrology
- Pediatric Surgery
- Immunology
Background:
- End-stage renal disease (ESRD) in children necessitates renal transplantation as the primary treatment.
- Successful pediatric kidney transplantation requires careful consideration of numerous patient-specific factors.
Purpose of the Study:
- To outline key considerations for optimizing pediatric renal transplantation timing and management.
- To review current and emerging immunosuppressive therapies for pediatric kidney transplant recipients.
- To identify persistent challenges and compare outcomes in pediatric versus adult renal transplantation.
Main Methods:
- Review of factors influencing pediatric renal transplant timing, including age, disease etiology, psychosocial status, donor type, and growth parameters.
- Assessment of pre-transplant immunizations and infectious disease screening (Epstein-Barr virus, cytomegalovirus, HIV, hepatitis A, B, C) for donor and recipient.
- Evaluation of standard immunosuppressive agents (prednisone, imuran, cyclosporine, T cell antibodies) and novel investigational therapies (FK-506, rapamycin, mofetil, brequinar, leflunomide, HLA-derived peptides).
Main Results:
- Key factors for determining optimal transplant timing include patient age, primary renal disease, psychosocial status, donor type, and growth status.
- Comprehensive immunizations and infectious disease screening are critical pre-transplant steps.
- Established immunosuppressants form the current standard, with several novel agents under investigation.
- Infection, rejection, and malignancy remain significant complications in pediatric renal transplantation.
- Despite improvements, pediatric renal transplant outcomes still lag behind those observed in young adults.
Conclusions:
- Optimizing pediatric renal transplantation involves a multidisciplinary approach addressing patient-specific factors and potential complications.
- Ongoing research into novel immunosuppressive therapies may improve outcomes, but challenges persist.
- Pediatric kidney transplant recipients require specialized long-term management to bridge the gap in outcomes compared to adult recipients.
Abstract:
Renal transplantation continues to be the goal of therapy for children with end-stage renal disease. Patient age, primary renal disease, psychosocial status, living versus cadaver donor allograft, optimal immunosuppressive therapy, urologic status, and maximization of growth and development must be considered in determining the optimal time for transplantation. Immunizations should be up to date, and the immune status of both the donor and the recipient with regard to Epstein-Barr virus, cytomegalovirus, human immunodeficiency virus, and hepatitis A, B, and C must be known. Prednisone, imuran, cyclosporine, and T cell antibodies remain the mainstay of immunosuppression. However, new therapies, such as FK-506, rapamycin, mofetil, brequinar, leflunomide, and human leukocyte antigen-derived peptides, are under investigation for use in transplantation. Complications, including infection, rejection, and malignancy, continue to be problematic in pediatric renal transplantation. Although patient and graft survival has improved over time, outcomes in pediatric renal transplantation continue to lag behind those in young adults.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management