Topics Discussed: renal transplantation; transplantation.
Sections: Epidemiology, Management Issues in the Renal Transplant Patient, Outcomes of Renal Transplantion, References.
Excerpt:"Pediatric end-stage renal disease is successfully managed with
either chronic dialysis or renal transplantation (see Chapters 477 and 478). Because transplantation
promotes more normal growth and development compared with chronic
dialysis, it is now the preferred approach to management.1,2 However,
the required chronic immunosuppression exposes children to multiple
complications and side effects (see Chapter 128),
so management strategies attempt to minimize or eliminate immunosuppression
while assuring graft survival. Many factors determine the optimal
time for transplant in the individual patient, including the patient
age, primary renal disease, psychosocial status, family dynamics, availability
of a living donor versus deceased donor allograft,
optimal immunosuppressive therapy, and maximization of growth and
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