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Current Anesthesiology Reports
Published in: Current Anesthesiology Reports 2/2018

01-06-2018 | Transplantation Anesthesia (KG Belani, Section Editor)

Issues in Pediatric Kidney Transplantation

Authors: Benjamin Kloesel, Priya S. Verghese, Kumar Belani

Published in: Current Anesthesiology Reports | Issue 2/2018

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Abstract

Purpose of Review

Pediatric kidney transplants have been performed for more than five decades. To achieve excellent patient outcomes, collaboration of multiple subspecialties is required. This manuscript will review recent advancements in different fields that relate to pediatric kidney transplantation.

Recent Findings

With improvements in patient selection, drugs, perioperative care, surgical technique and postoperative monitoring, outcomes including graft survival, patient survival, and delayed graft function/primary non-function have improved. Immunosuppressive regimens that minimize corticosteroids are increasingly implemented and long-term side effects of antirejection drugs such as infections and metabolic/endocrine dysregulation are better understood. The anesthetic management of pediatric kidney recipients has remained largely the same over the years, but newer technologies and drugs are beginning to be implemented.

Summary

The field of pediatric kidney transplantation has seen significant improvements in outcomes but still suffers from a discrepancy between graft demand and supply. The future will likely see efforts directed towards improved graft allocation policies, attempts to increase living donations, and new approaches such as alternative graft sources from tissue engineering and recovery of kidney function using regenerative medicine.
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Metadata
Title
Issues in Pediatric Kidney Transplantation
Authors
Benjamin Kloesel
Priya S. Verghese
Kumar Belani
Publication date
01-06-2018
Publisher
Springer US
Published in
Current Anesthesiology Reports / Issue 2/2018
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-018-0269-2

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