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Review
. 2021 Aug 1;26(4):356-359.
doi: 10.1097/MOT.0000000000000898.

Pediatric kidney transplantation, a technical update

Kambiz Etesami  1   2 , Rachel Hogen  1   2 , Rachel Lestz  2
Affiliations
Review

Pediatric kidney transplantation, a technical update

Kambiz Etesami et al. Curr Opin Organ Transplant. .

Abstract

Purpose of review: Pediatric kidney transplantation is the definitive therapy for infants and children suffering from renal failure. It is a distinct endeavor demanding specialized care for optimal results. This includes a dedicated preoperative workup accounting for unique predisposing urologic conditions, specialized surgical techniques, and careful hemodynamic monitoring and maintenance.

Recent findings: Historically, size-matched renal allografts from pediatric donors to pediatric recipients suffered from poor outcomes. Advances in surgical technique performed at high volume centers have shown that these operations can be performed safely, helping expand the donor pool for these patients. Concurrently, transplantation of increasingly small for size infants with complex medical and surgical backgrounds has become a reality.

Summary: On a policy front, efforts to expand access to size-matched organs, combined with advances in medical management and immunosuppression have seen pediatric renal transplantation reach new heights. Now, these breakthroughs are heightened by the ability to transplant such organs into the smallest infants. The net result will be diminished transplant waiting times and, accordingly, improved quality of life and longevity for children suffering from renal failure.

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References

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    1. Beetz O, Weigle C, Nogly R, et al. Surgical complications in pediatric kidney transplantation - incidence, risk factors, and effects on graft survival: a retrospective single-center study. Pediatr Transplant 2021; 25:e13871.
    1. Torricelli F, Watanabe A, Piovesan A, et al. Urologic issues in pediatric transplant recipients. Transl Androl Urol 2019; 8:134–140.
    1. Tsai E, Ettenger R. Kidney transplantation in children. L Handbook of kidney transplantation. 5 th editionDanovitch GMPhiladelphia, PALipincott Williams & Wilkins 2010.
    1. Smith M, Windsperger A, Alanee S, et al. Risk factors and treatment success for ureteral obstruction after pediatric renal transplantation. J Urol 2010; 183:317–322.