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[Kidney transplantation in the child]
1Universitäts-Kinderklinik Zürich.
Schweizerische Medizinische Wochenschrift
|June 14, 1997
Summary
Living related donor transplantation is crucial for pediatric end-stage renal failure due to donor shortages. Despite challenges like vascular thrombosis and infections, long-term outcomes for pediatric kidney transplants are very satisfactory, improving survival and quality of life.
Area of Science:
- Pediatric Nephrology
- Transplantation Surgery
- Immunology
Context:
- End-stage renal failure in children necessitates kidney transplantation.
- Cadaveric kidney shortages increasingly require consideration of living related donor transplantation (LRT).
- Pediatric transplant candidates often present with congenital/hereditary diseases, specific dialysis methods, and growth issues.
Purpose:
- To highlight the unique considerations and challenges in pediatric living related donor transplantation.
- To outline management strategies for pediatric kidney transplant recipients.
- To discuss long-term outcomes and quality of life post-transplantation in children.
Summary:
- Pediatric kidney transplantation, particularly LRT, is vital for end-stage renal failure.
- Key challenges include managing pre-transplant conditions, surgical risks (e.g., vascular thrombosis), post-operative complications (e.g., infections, rejection), and graft-specific issues.
- Adult kidneys can be used in pediatric recipients weighing ≥10 kg, with careful management of central venous pressure and anticoagulation.
Impact:
- LRT offers a viable solution to cadaveric kidney shortages in pediatric patients.
- Effective management of pediatric kidney transplant recipients can mitigate risks like thrombosis, rejection, and infection.
- Successful pediatric kidney transplantation leads to satisfactory long-term survival and improved quality of life, including social integration.