Pearls and Pitfalls in Pediatric Kidney Transplantation After 5 Decades

被引:15
作者
Oomen, Loes [1 ]
Bootsma-Robroeks, Charlotte [2 ,3 ]
Cornelissen, Elisabeth [2 ]
de Wall, Liesbeth [1 ]
Feitz, Wout [1 ]
机构
[1] Radboudumc Amalia Childrens Hosp, Dept Urol, Div Pediat Urol, Nijmegen, Netherlands
[2] Radboudumc Amalia Childrens Hosp, Dept Pediat Nephrol, Nijmegen, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Beatrix Childrens Hosp, Dept Pediat,Pediat Nephrol, Groningen, Netherlands
来源
FRONTIERS IN PEDIATRICS | 2022年 / 10卷
关键词
pediatric kidney transplantation; graft survival; pediatric urology; pediatric nephrology; immunosuppression; donor selection; lower urinary tract dysfunction; LOWER URINARY-TRACT; PLURIPOTENT STEM-CELLS; SIMULTANEOUS BILATERAL-NEPHRECTOMY; RENAL-TRANSPLANTATION; DECEASED DONOR; VESICOURETERAL REFLUX; MEDICATION ADHERENCE; STEROID WITHDRAWAL; LIVING DONATION; RISK-FACTORS;
D O I
10.3389/fped.2022.856630
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Worldwide, over 1,300 pediatric kidney transplantations are performed every year. Since the first transplantation in 1959, healthcare has evolved dramatically. Pre-emptive transplantations with grafts from living donors have become more common. Despite a subsequent improvement in graft survival, there are still challenges to face. This study attempts to summarize how our understanding of pediatric kidney transplantation has developed and improved since its beginnings, whilst also highlighting those areas where future research should concentrate in order to help resolve as yet unanswered questions. Existing literature was compared to our own data of 411 single-center pediatric kidney transplantations between 1968 and 2020, in order to find discrepancies and allow identification of future challenges. Important issues for future care are innovations in immunosuppressive medication, improving medication adherence, careful donor selection with regard to characteristics of both donor and recipient, improvement of surgical techniques and increased attention for lower urinary tract dysfunction and voiding behavior in all patients.
引用
收藏
页数:23
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