Top

Published in:

01-05-2016 | Educational Review

Renal transplantation in infants

Authors: Hannu Jalanko, Ilkka Mattila, Christer Holmberg

Published in: Pediatric Nephrology | Issue 5/2016

Abstract

Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.

Najarian JS, Simmons RL, Tallent MB, Kiellstrand CM, Buselmeier TJ, Vernier RL, Michael AF (1971) Renal transplantation in infants and children. Ann Surg 174:583–600CrossRefPubMedPubMedCentral

Chavers B, Najarian JS, Humar A (2007) Kidney transplantation in infants and small children. Pediatr Transplant 11:702–708CrossRefPubMed

van Stralen KJ, Borzych-Duzalka D, Hataya H, Kennedy SE, Jager KJ, Verrina E, Inward C, Rönnholm K, Vondrak K, Warady BA, Zurowska AM, Schaefer F, Cochat P, ESPN/ERA-EDTA registry; IPPN registry; ANZDATA registry; Japanese RRT registry (2014) Survival and clinical outcomes of children starting renal replacement therapy in the neonatal period. Kidney Int 86:468–174

Pruthi R, O’Brien C, Casula A, Braddon F, Lewis M, Maxwell H, Tse Y, Inward C, Sinha MD (2013) UK Renal registry 15th annual report: chapter 4 demography of the UK paediatric renal replacement therapy population in 2011. Nephron Clin Pract 123:81–92CrossRefPubMed

Smith JM, Martz K, Blydt-Hansen TD (2013) Pediatric kidney transplant practice patterns and outcome benchmarks, 1987–2010: a report of the North American pediatric renal trials and collaborative studies. Pediatr Transplant 17:149–157CrossRefPubMed

Rees L (2008) Management of the neonate with chronic renal failure. Semin Fetal Neonatal Med 13:181–188CrossRefPubMed

Wühl E, van Stralen KJ, Verrina E, Bjerre A, Wanner C, Heaf JG, Zurriaga O, Hoitsma A, Niaudet P, Palsson R, Ravani P, Jager KJ, Schaefer F (2013) Timing of renal replacement therapy in patients with congenital malformations of the kidney and urinary tract. Clin J Am Soc Nephrol 8:67–74CrossRefPubMedPubMedCentral

Warady BA, Neu A, Schaefer F (2014) Optimal care of the infant, child, and adolescent on dialysis: 2014 update. Am J Kidney Dis 64:128–142CrossRefPubMed

Watson AR, Hayes WN, Vondrak K, Ariceta G, Schmitt CP, Ekim M, Fischbach M, Edefonti A, Shroff R, Holta T, Zurowska A, Klaus G, Bakkaloglu S, Stefanidis CJ, Van de Walle J, European Paediatric Dialysis Working Group (2013) Factors influencing choice of renal replacement therapy in European pediatric nephrology units. Pediatr Nephrol 28:2361–2368CrossRefPubMed

10.

Querfeld U, Stefanidis CJ (2012) Pediatrics: when should children surviving a Wilms tumor be transplanted? Nat Rev Nephrol 8:443–444CrossRefPubMed

11.

Khositseth S, Askiti V, Nevins TE, Matas AJ, Ingulli EG, Najarian JS, Gillingham KJ, Chavers BM (2007) Increased urologic complications in children after kidney transplants for obstructive and reflux uropathy. Am J Transplant 7:2152–2157CrossRefPubMed

12.

González-Jorge AL, Hernández-Plata JA, Bracho-Blanchet E, Raya-Rivera AM, Romero-Navarro B, Reyes-López A, Varela-Fascinetto G (2010) Should a complex uropathy be a contraindication for renal transplantation in children? Transplant Proc 42:2365–2368CrossRefPubMed

13.

Christman MS, Canning DA, Schast AP, Baluarte HJ, Kaplan BS (2013) Renal transplantation into a diverted urinary system–is it safe in children? J Urol 190:678–682CrossRefPubMed

14.

Lopez Pereira P, Ortiz Rodriguez R, Fernandez Camblor C, Martínez Urrutia MJ, Lobato Romera R, Espinosa L, Jaureguizar Monereo E (2013) Renal transplant outcome in children with augmented bladder. Front Pediatr 1:42CrossRefPubMedPubMedCentral

15.

Goldberg AM, Amaral S, Moudgil A (2014) Developing a framework for evaluating kidney transplant candidacy in children with multiple comorbidities. Pediatr Nephrol 30:5–13CrossRefPubMed

16.

Cransberg K, Smits JM, Offner G, Nauta J, Persijn GG (2006) Kidney transplantation without prior dialysis in children: the Eurotransplant experience. Am J Transplant 6:1858–1864CrossRefPubMed

17.

Muzaale AD, Massie AB, Wang MC, Montgomery RA, McBride MA, Wairight JL, Segev DL (2014) Risk of end-stage renal disease following live kidney donation. JAMA 311:579–586CrossRefPubMedPubMedCentral

18.

Mjøen G, Hallan S, Hartmann A, Foss A, Midtvedt K, Øyen O, Reisæter A, Pfeffer P, Jenssen T, Leivestad T, Line PD, Øvrehus M, Dale DO, Pihlstrøm H, Holme I, Dekker FW, Holdaas H (2014) Long-term risks for kidney donors. Kidney Int 86:162–167CrossRefPubMed

19.

Foster BJ, Dahhou M, Zhang X, Platt RW, Hanley JA (2013) Relative importance of HLA mismatch and donor age to graft survival in young kidney transplant recipients. Transplantation 96:469–475CrossRefPubMed

20.

Amaral S, Patzer RE, Kutner N, McClellan W (2012) Racial disparities in access to pediatric kidney transplantation since share 35. J Am Soc Nephrol 23:1069–1077CrossRefPubMed

21.

Foster BJ, Dahhou M, Zhang X, Platt RW, Smith JM, Hanley JA (2014) Impact of HLA mismatch at first kidney transplant on lifetime with graft function in young recipients. Am J Transplant 14:876–885CrossRefPubMed

22.

Persijn GG (2006) Allocation of organs, particularly kidneys, within Eurotransplant. Hum Immunol 67:419–426CrossRefPubMed

23.

Gondos A, Döhler B, Brenner H, Opelz G (2013) Kidney graft survival in Europe and the United States: strikingly different long-term outcomes. Transplantation 95:267–274CrossRefPubMed

24.

Yoo P, Olthoff KM, Abt PL (2011) Donation after cardiac death in pediatric organ transplantation. Curr Opin Organ Transplant 16:483–488CrossRefPubMed

25.

Talbot D, Achilles OA, Mirza D, Buckels J, Mayer AD, Milford DV (1998) Early risk factors in pediatric renal transplantation at a single center. J Pediatr Surg 33:1396–1398CrossRefPubMed

26.

Johnson RJ, Armstrong S, Belger MA, Fuggle SV, Martin S, Middleton D, Ray TC, Rigden SP, Verrier-Jones K, Morris PJ, Paediatric Task Force of United Kingdom Transplant, Bristol, UK (2002) The outcome of pediatric cadaveric renal transplantation in the UK and Eire. Pediatr Transplant 6:367–377CrossRefPubMed

27.

Mitsnefes M, Stablein D (2005) Hypertension in pediatric patients on long-term dialysis: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Am J Kidney Dis 45:309–315CrossRefPubMed

28.

Sarwal MM, Cecka JM, Millan MT, Salvatierra O Jr (2000) Adult-size kidneys without acute tubular necrosis provide exceedingly superior long-term graft outcomes for infants and small children. Transplantation 70:1728–1736CrossRefPubMed

29.

Dubourg L, Cochat P, Hadj-Aïssa A, Tydén G, Berg UB (2002) Better long-term functional adaptation to the child’s size with pediatric compared to adult kidney donors. Kidney Int 62:1454–1460CrossRefPubMed

30.

Becker T, Neipp M, Reichart B, Pape L, Ehrtich J, Klempnauer J, Offner G (2006) Paediatric kidney transplantation in small children—a single-centre experience. Transplant Int 19:197–202CrossRef

31.

Zhao WY, Zhang L, Zhu YH, Chen Y, Zhu FY, Shen Q, Xu H, Zeng L (2014) En bloc kidneys transplanted from infant donors less than 5 kg into pediatric recipients. Transplantation 97:555–558CrossRefPubMed

32.

Opelz G, Morath C, Süsal C, Tran TH, Zeler M, Döhler B (2015) Three-year outcomes following 1,420 ABO-incompatible living donor kidney transplants performed after ABO antibody reduction: results from 101 centers. Transplantation 99:400–404CrossRefPubMed

33.

Murmatsu M, Gonzalez HD, Cacciola R, Aikawa A, Yaqoob MM, Puliatti C (2014) ABO incompatible renal transplants: good or bad? World J Transplant 4:18–29CrossRef

34.

Tydén G, Kumlien G, Berg UB (2011) ABO-incompatible kidney transplantation in children. Pediatr Transplant 15:502–504CrossRefPubMed

35.

Urschel S, Larsen IM, Kirk R, Flett J, Burch M, Shaw N, Birnbaum J, Netz H, Pahl E, Matthews KL, Chinnock R, Johnston JK, Derkatz K, West LJ (2013) ABO-incompatible heart transplantation in early childhood: an international multicentre study of clinical experiences and limits. J Heart Lung Transplant 32:285–292CrossRefPubMed

36.

Salvatierra O Jr, Millan M, Concepcion W (2006) Pediatric renal transplantation with considerations for successful outcome. Semin Pediatr Surg 15:208–217CrossRefPubMed

37.

Englund M, Berg U, Tydén G (2003) A longitudinal study of children who received renal transplants 10–20 years ago. Transplantation 76:311–318CrossRefPubMed

38.

Carey WA, Talley LI, Sehring SA, Jaskula JM, Mathias RS (2007) Outcomes of dialysis initiated during the neonatal period for treatment of end-stage renal disease: a North American pediatric renal trials and collaborative studies special analysis. Pediatrics 119:e468–e473CrossRefPubMed

39.

Coulthard MG, Crosier J (2002) Outcome of reaching end stage renal failure in children under 2 years of age. Arch Dis Child 87:511–517CrossRefPubMedPubMedCentral

40.

Neipp M, Offner G, Lück R, Latta K, Strehlau J, Schlitt HJ, Ehrich JH, Klempnauer J, Br N (2002) Kidney transplantation in children weighing less than 15 kg: donor selection and technical considerations. Transplantation 73:409–416CrossRefPubMed

41.

Vitola SP, Gnatta D, Garcia VD, Garcia CD, Bittencourt VB, Keitel E, Pires FS, D’Avila AR, Silva JG, Amaral RL, Santos LN, Kruel CD (2013) Kidney transplantation in children weighing less than 15 kg: extraperitoneal access-experience with 62 cases. Pediatr Transplant 17:445–453CrossRefPubMed

42.

Salvatierra O Jr, Singh T, Shifrin R, Conley S, Alexander S, Tanney D, Lemley K, Sarwal M, Mackle F, Elfrey E, Orlandi P, Zarins C, Herfkens R (1998) Successful transplantation of adult-sized kidneys into infants requires maintenance of high aortic blood flow. Transplantation 66:819–823CrossRefPubMed

43.

Fanta S, Backman JT, Seikku P, Holmberg C, Hoppu K (2005) Cyclosporine A monitoring—how to account for twice and three times daily dosing. Pediatr Nephrol 20:591–596CrossRefPubMed

44.

Li L, Chang A, Naesens M, Kambham N, Waskewitz J, Martin J, Wong C, Alexander S, Grimm P, Concepcion W, Salvatierra O, Sarwall MM (2009) Steroid-free immunosuppression since 1999: 129 pediatric renal transplants with sustained graft and patient benefits. Am J Transplant 9:1362–1372CrossRefPubMedPubMedCentral

45.

Tainio J, Qvist E, Hölttä T, Pakarinen M, Jahnukainen T, Jalanko H (2014) Metabolic risk factors and long-term function after pediatric renal transplantation. Transplant Int 27:583–592CrossRef

46.

Seikku P, Raivio T, Jänne OA, Neuvonen PJ, Holmberg C (2006) Methylprednisolone exposure in pediatric renal transplant patients. Am J Transplant 6:1451–1458CrossRefPubMed

47.

Smith JM, Stablein DM, Munoz R, Hebert D, McDonald RA (2007) Contributions of the transplant registry: the 2006 annual report of the North American pediatric renal trials and collaborative studies (NAPRTCS). Pediatr Transplant 11:366–373CrossRefPubMed

48.

McDonald RA, Smith JM, Stablein D, Harmon WE (2003) Pretransplant peritoneal dialysis and graft thrombosis following pediatric kidney transplantation: a NAPRTCS report. Pediatr Transplant 7:204–208CrossRefPubMed

49.

Gholami S, Sarwal MM, Naesens M, Ringertz HG, Barth RA, Balise RR, Salvatierra O (2010) Standardizing resistive indices in healthy pediatric transplant recipients of adult-sized kidneys. Pediatr Transplant 14:126–131CrossRefPubMed

50.

Qvist E, Their M, Krogerus L, Holmberg C, Jalanko H (2007) Early treatment of acute rejections gives favorable long-term function after renal transplantation in small children. Pediatr Transplant 11:895–900CrossRefPubMed

51.

Their M, von Willebrand E, Taskinen E, Rönnholm K, Holmberg C, Jalanko H (2001) Fine-needle aspiration biopsy allows early detection of acute rejection in children after renal transplantation. Transplantation 71:736–743CrossRefPubMed

52.

Ginevri F, Nocera A, Comoli P, Innocente A, Cioni M, Parodi A, Fontana I, Magnasco A, Nocco A, Tagliamacco A, Sementa A, Ceriolo P, Ghio L, Zecca M, Cardillo M, Gariboto G, Ghiggeri GM, Poli F (2012) Posttransplant de novo donor-specific hla antibodies identify pediatric kidney recipients at risk for late antibody-mediated rejection. Am J Transplant 12:3355–3362CrossRefPubMed

53.

Kim JJ, Balasubramanian R, Michaelides G, Wittenhagen P, Sebire NJ, Mamode N, Shaw O, Vaughan R, Marks SD (2014) The clinical spectrum of de novo donor-specific antibodies in pediatric renal transplant recipients. Am J Transplant 14:2350–2358CrossRefPubMed

54.

Miettinen J, Peräsaari J, Lauronen J, Qvist E, Valta H, Pakarinen M, Merenmies J, Jalanko H (2012) Donor-specific HLA-antibodies and graft function after renal transplantation. Pediatr Nephrol 27:1011–1019CrossRefPubMed

55.

Their M, Holmberg C, Lautenschlager I, Höckerstedt K, Jalanko H (2000) Infections in pediatric kidney and liver transplant patients after perioperative hospitalization. Transplantation 69:1617–1623CrossRefPubMed

56.

Pereira PL, Urrutia MJ, Lobato R, Jaureguizar R (2014) Renal transplantation in augmented bladders. Curr Urol Rep 5:431–433CrossRef

57.

Comoli P, Ginevri F (2012) Monitoring and managing viral infections in pediatric transplant recipients. Pediatr Nephrol 27:705–717CrossRefPubMed

58.

McDonald RA, Smith JM, Ho M, Lindblad R, Ikle D, Grimm P, Wyatt R, Arar M, Liereman D, Gridges N, Harmon W, CCTPT Study Group (2008) Incidence of PTLD in pediatric renal transplant recipients receiving basiliximab, calcineurin inhibitor, sirolimus and steroids. Am J Transplant 8:984–949CrossRefPubMed

59.

Smith JM, Dhamidharka VR, Talley L, Martz K, McDonald RA (2007) BK virus nephropathy in pediatric renal transplant recipients: an analysis of the North American pediatric renal trials and collaborative studies (NAPRTCS) registry. Clin J Am Soc Nephrol 2:1037–1042CrossRefPubMed

60.

Smith JM, Dharnidharka VR (2015) Viral surveillance and subclinical viral infection in pediatric kidney transplantation. Pediatr Nephrol 30:741–748CrossRefPubMed

61.

Höcker B, Fickenscher H, Delecluse HJ, Böhm S, Küsters U, Schnitzler P, Pohl M, John U, Kemper MJ, Fehrenbach H, Wigger M, Holder M, Schröder M, Billing H, Fichtner A, Feneberg R, Sander A, Köpf-Shakib S, Süsal C, Tönshoff B (2013) Epidemiology and morbidity of Epstein–Barr virus infection in pediatric renal transplant recipients; a multicenter, prospective study. Clin Infect Dis 56:84–92CrossRefPubMed

62.

Tejani A, Ho PL, Emmett L, Stablein DM, North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) (2002) Reduction in acute rejections decreases chronic rejection graft failure in children: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Am J Transplant 2:142–147CrossRefPubMed

63.

Haas M (2014) An updated Banff schema for diagnosis of antibody-mediated rejection in renal allografts. Curr Opin Organ Transplant 19:315–322CrossRefPubMed

64.

Dart AB, Schall A, Gibson IW, Blydt-Hansen TD, Birk PE (2010) Patterns of chronic injury in pediatric renal allografts. Transplantation 89:334–340CrossRefPubMed

65.

Miettinen J, Helin H, Pakarinen M, Jalanko H, Lauronen J (2014) Histopathology and biomarkers in prediction of renal function in children after kidney transplantation. Transplant Immunol 31:105–111CrossRef

66.

Fine RN, Martz K, Stablein D (2010) What have 20 years of data from the North American Pediatric Renal Transplant Cooperative Study taught us about growth following renal transplantation in infants, children, and adolescence with renal end-stage renal disease? Pediatr Nephrol 25:739–746CrossRefPubMed

67.

Qvist E, Marttinen E, Rönnholm K, Antikainen M, Jalanko H, Sipilä I, Holmberg C (2002) Growth after renal transplantation in infancy or early childhood. Pediatr Nephrol 17:438–443CrossRefPubMed

68.

Harambat J, Cochat P (2009) Growth after renal transplantation. Pediatr Nephrol 24:1297–1306CrossRefPubMedPubMedCentral

69.

Tainio J, Qvist E, Vehmas R, Jahnukainen K, Hölttä T, Valta H, Jahnukainen T, Jalanko H (2011) Pubertal development is normal in adolescents after renal transplantation in childhood. Transplantation 92:404–409CrossRefPubMed

70.

Franke D, Winkel S, Gellerman J, Querfeld U, Pape L, Ehrich JH, Haffner D, Pavičić L, Zivičnjak M (2013) Growth and maturation improvement in children on renal replacement therapy over the past 20 years. Pediatr Nephrol 28:2042–2051

71.

Wy Y, Cheng W, Yang XD, Xiang B (2013) Growth hormone improves growth in pediatric renal transplant recipients—a systematic review and meta-analysis of randomized controlled trials. Pediatr Nephrol 28:129–133CrossRef

72.

Longmore DK, Conwell LS, Burke JR, McDonald SP, McTaggart SJ (2013) Post-transplant lymphoproliferative disorder: no relationship to recombinant human growth hormone use in Australian and New Zealand pediatric kidney transplant recipients. Pediatr Transplant 17:731–716CrossRefPubMed

73.

Rees L, Greene SA, Adlard P, Jones J, Haycock GB, Ridgen SP, Preece M, Chantler C (1988) Growth and endocrine function after renal transplantation. Arch Dis Child 63:1326–1332CrossRefPubMedPubMedCentral

74.

Ghanem ME, Emam ME, Albaghdady LA, Bakr NI, Helal AS, Sadek EE, Sobh MA (2010) Effect of childhood kidney transplantation on puberty. Fertile Steril 94:2248–2252CrossRef

75.

Tainio J, Jahnukainen T, Nurmio M, Pakarinen M, Jalanko H, Jahnukainen T (2014) Testicular function, semen quality, and fertility in young men after renal transplantation during childhood and adolescence. Transplantation 98:987–993CrossRefPubMed

76.

Haffner D, Schüler U (2014) Metabolic bone disease after renal transplantation. Curr Opin Pediatr 26:198–206CrossRefPubMed

77.

Helenius I, Remes V, Salminen S, Valta H, Mäkitie O, Holmberg C, Palmu P, Tervahartiala P, Sarna S, Helenius M, Peltonen J, Jalanko H (2006) Incidence and predictors of fractures in children after solid organ transplantation: a 5-year prospective, population-based study. J Bone Miner Res 21:380–387CrossRefPubMed

78.

Valta H, Mäkitie O, Rönnholm K, Jalanko H (2009) Bone health in children and adolescents after renal transplantation. J Bone Miner Res 24:1699–1708CrossRefPubMed

79.

Bacchetta J, Ranchin B, Demède D, Allard L (2013) The consequences of pediatric renal transplantation on bone metabolism and growth. Curr Opin Organ Transplant 18:555–562CrossRefPubMed

80.

Ramirez-Cortes G, Fuentas-Valesco Y, García-Roca P, Guadarrama O, López M, Valverde-Rosas S, Velásquez-Jones L, Romero B, Toussaint G, Medeiros M (2009) Prevalence of metabolic syndrome and obesity in renal transplanted Mexican children. Pediatr Transplant 14:351–357

81.

Mistnefes MM, Khoury P, McEnery PT (2002) Body mass index and allograft function in pediatric renal transplantation. Pediatr Nephrol 17:535–539CrossRef

82.

Sorof JM, Sullivan EK, Tejani A, Portman RJ (1999) Antihypertensive medication and renal allograft failure: a North American Pediatric Renal Transplant Cooperative Study report. J Am Soc Nephrol 10:1324–1330PubMed

83.

Prokai A, Fekete A, Kis E, Reusz GS, Sallay P, Korner A, Wagner L, Tulassay T, Szabo AJ (2008) Post-transplant diabetes mellitus in children following renal transplantation. Pediatr Transplant 12:643–649CrossRefPubMed

84.

Oblak M, Kandus A, Mlinšek G, Buturović-Ponikvar J, Arnol M (2013) Increase in proteinuria after acute kidney graft rejection is associated with decreased graft function and survival. Transplant Proc 45:1453–1457CrossRefPubMed

85.

Johnson RJ, Warady BA (2013) Long-term neurocognitive outcomes of patients with end-stage renal disease during infancy. Pediatr Nephrol 28:1283–1291CrossRefPubMed

86.

Qvist E, Pihko H, Fagerudd P, Valanne L, Lamminranta S, Karikoski J, Sainio K, Rönnholm K, Jalanko H, Holmberg C (2002) Neurodevelopmental outcome in high-risk patients after renal transplantation in early childhood. Pediatr Transplant 6:53–62CrossRefPubMed

87.

Haavisto A, Korkman M, Holmberg C, Jalanko H, Qvist E (2012) Neuropsychological profile of children with kidney transplants. Nephrol Dial Transplant 27:2594–2601CrossRefPubMed

88.

Laakkonen H, Taskinen S, Rönnholm K, Holmbrg C, Sandberg S (2014) Parent-child and spousal relationships in families with a young child with end-stage renal disease. Pediatr Nephrol 29:289–295CrossRefPubMed

89.

Qvist E, Närhi V, Apajasalo M, Rönnholm K, Jalanko H, Almqvist F, Holmberg C (2004) Psychosocial adjustment and quality of life after renal transplantation in early childhood. Pediatr Transplant 8:120–125CrossRefPubMed

90.

Diseth TH, Tangeraas T, Reinfjell T, Bjerre A (2011) Kidney transplantation in childhood: mental health and quality of life of children and caregivers. Pediatr Nephrol 26:1881–1892CrossRefPubMedPubMedCentral

91.

Haavisto A, Jalanko H, Sintonen H, Holmberg C, Qvist E (2011) Quality of life in adult survivors of pediatric kidney transplantation. Transplantation 92:1322–1326CrossRefPubMed

92.

Kärrfelt HM, Berg UB (2008) Long-term psychosocial outcome after renal transplantation during childhood. Pediatr Transplant 12:557–562CrossRefPubMed

93.

Anthony SJ, Pollock Barziv S, Ng VL (2010) Quality of life after pediatric solid organ transplantation. Pediatr Clin N Am 57:559–574CrossRef

94.

Tozzi A, Mazzotti E, Di Clommo VM, Dello Strologo L, Cuttini M (2012) Quality of life in a cohort of patients diagnosed with renal failure in childhood and who received renal transplant. Pediatr Transplant 16:840–845CrossRefPubMed

95.

Dharnidharka VR, Fiorina P, Harmon WE (2014) Kidney transplantation in children. N Engl J Med 371:549–558CrossRefPubMed

96.

Andreoni KA, Forbes R, Andreoni RM, Phillips G, Stewart H, Ferris M (2013) Age-related kidney transplant outcomes. Health disparities amplified in adolescence. JAMA Intern Med 173:1524–1532CrossRefPubMed

Title: Renal transplantation in infants
Authors: Hannu Jalanko
Ilkka Mattila
Christer Holmberg
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 5/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-015-3144-0

At a glance: The STEP trials

Springer Medicine

Renal transplantation in infants

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2016

Renal abnormalities in a cohort of HIV-infected children and adolescents

HNF1B-associated clinical phenotypes: the kidney and beyond

Smaller circuits for smaller patients: improving renal support therapy with Aquadex™

Tubular atrophy in the pathogenesis of chronic kidney disease progression

Comparison of reticulocyte hemoglobin equivalent with traditional markers of iron and erythropoiesis in pediatric dialysis

How does your kidney smell? Emerging roles for olfactory receptors in renal function