Document Detail


Renal transplantation in the pediatric age
MedLine Citation:
PMID:  12754454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Renal transplantation is the optimal and preferred treatment for children with end-stage renal disease. Pediatric kidney transplantation results have improved significantly over the years and the actuarial survival of the children with renal transplantation has become excellent. These improvements are due to many factors, including better immunosuppressive regimens and therefore a decrease in acute rejection episodes and possible improvement of graft survival. The concentration of care in specialized pediatric transplantation centers allowed the improvement of kidney transplants also in children less than 6 years old. The same success is not always achieved in infants. The selection of the donor is another important factor. The survival rate of renal transplantation is better in case of living-related donors. Renal transplants performed from cadaveric donors <6 years of age have an actuarial survival lower than renal transplants from cadaver donors >6 years of age. Owing to the limited members of cadaveric kidneys available for transplants, also the donors <6 years old are sometimes a valuable resource. As far as HLA-matching and its relationship with renal transplant outcome is concerned, there are conflicting data, but important registers on adults and children show the positive relationship between histocompatibility matching and graft outcome. A major distinguishing feature of pediatric from adult renal recipients is the need for children to grow. It is well known that chronic renal insufficiency involves a growth failure. A functioning transplant may improve the growth, but a catch-up growth is rarely achieved. To overcome this problem many techniques, such as alternate-day steroid therapy, discontinuation of prednisone, the use of recombinant growth hormone, have been adopted. As to social rehabilitation, transplanted children attend the school and work more than dialyzed ones.
Authors:
L Ghio; R Garavaglia
Publication Detail:
Type:  English Abstract; Journal Article; Review    
Journal Detail:
Title:  Minerva pediatrica     Volume:  55     ISSN:  0026-4946     ISO Abbreviation:  Minerva Pediatr.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-05-19     Completed Date:  2003-11-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0400740     Medline TA:  Minerva Pediatr     Country:  Italy    
Other Details:
Languages:  ita     Pagination:  103-8     Citation Subset:  IM    
Affiliation:
U.O. Dialisi e Trapianto Pediatrico, Dipartimento di Pediatria, Clinica Pediatrica, G. e D. De Marchi di Milano, Milano, Italy.
Vernacular Title:
Trapianto renale in età pediatrica.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Child
Child, Preschool
Growth Disorders / etiology,  prevention & control
Hospitals, Pediatric
Hospitals, Special
Humans
Immunosuppression / adverse effects
Infant
Kidney Transplantation* / rehabilitation,  statistics & numerical data
Postoperative Complications / prevention & control
Tissue Donors / statistics & numerical data
Tissue and Organ Procurement / statistics & numerical data
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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