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Kidney Transplant in Adolescents: Medical Aspects

  • Jessica Brennan
  • Paul Brakeman
Chapter

Abstract

Adolescent kidney transplant recipients represent a unique group of patients with medical needs that are shaped by the physical changes that occur during puberty and the social transition from childhood to adulthood. In this chapter, we have focused on the medical and developmental challenges and opportunities that occur while caring for the adolescent pre- and post-kidney transplant patient. With the dedicated support of a multidisciplinary transplant team, we can achieve successful long-term kidney transplant outcomes for adolescent patients with end-stage renal disease.

Keywords

End-stage renal disease GFR Pre-transplant evaluation Hypercoagulability Cytomegalovirus Epstein-Barr virus Reproductive health Dermatology 

References

  1. 1.
  2. 2.
    Hebert SA, Swinford RD, Hall DR, Au JK, Bynon JS. Special considerations in pediatric kidney transplantation. Adv Chronic Kidney Dis. 2017;24(6):398–404.CrossRefGoogle Scholar
  3. 3.
    Verghese PS. Pediatric kidney transplantation: a historical review. Pediatr Res. 2017;81(1–2):259–64.CrossRefGoogle Scholar
  4. 4.
    Hart A, Smith JM, Skeans MA, Gustafson SK, Stewart DE, Cherikh WS, Wainright JL, Kucheryavaya A, Woodbury M, Snyder JJ, Kasiske BL, Israni AKOPTN. SRTR 2015 annual data report: kidney. Am J Transplant. 2017;17(Suppl 1):21–116.CrossRefGoogle Scholar
  5. 5.
    Tong A, Tjaden L, Howard K, Wong G, Morton R, Craig JC. Quality of life of adolescent kidney transplant recipients. J Pediatr. 2011;159(4):670–5.CrossRefGoogle Scholar
  6. 6.
    Tong A, Wong G, McTaggart S, Henning P, Mackie F, Carroll RP, Howard K, Craig JC. Quality of life of young adults and adolescents with chronic kidney disease. J Pediatr. 2013;163(4):1179–85.CrossRefGoogle Scholar
  7. 7.
    Reed-Knight B, Lee JL, Cousins LA, Mee LL. Intellectual and academic performance in children undergoing solid organ pretransplant evaluation. Pediatr Transplant. 2015;19(2):229–34.CrossRefGoogle Scholar
  8. 8.
    Korus M, Stinson JN, Pool R, Williams A, Kagan S. Exploring the information needs of adolescents and their parents throughout the kidney transplant continuum. Prog Transplant. 2011;21(1):53–60.CrossRefGoogle Scholar
  9. 9.
    Connelly J, Pilch N, Oliver M, Jordan C, Fleming J, Meadows H, Baliga P, Nadig S, Twombley K, Shatat I, Taber D. Prediction of medication non-adherence and associated outcomes in pediatric kidney transplant recipients. Pediatr Transplant. 2015;19(5):555–62.CrossRefGoogle Scholar
  10. 10.
    Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2017. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
  11. 11.
    Neu AM. Immunizations in children with chronic kidney disease. Pediatr Nephrol. 2012;27(8):1257–63.CrossRefGoogle Scholar
  12. 12.
    Winnicki E, Dharmar M, Tancredi D, Butani L. Comparable survival of en bloc versus standard donor kidney transplants in children. J Pediatr. 2016;173:169–74.CrossRefGoogle Scholar
  13. 13.
    Parajuli S, Lockridge JB, Langewisch ED, Norman DJ, Kujovich JL. Hypercoagulability in kidney transplant recipients. Transplantation. 2016;100(4):719–26.CrossRefGoogle Scholar
  14. 14.
    Dick AA, Lerner SM, Boissy AR, Farrell CE, Alfrey EJ. Excellent outcome in infants and small children with thrombophilias undergoing kidney transplantation. Pediatr Transplant. 2005;9(1):39–42.CrossRefGoogle Scholar
  15. 15.
    Gülhan B, Tavil B, Gümrük F, Aki TF, Topaloglu R. Renal transplantation experience in a patient with factor V Leiden homozygous, MTHFR C677T heterozygous, and PAI heterozygous mutation. Pediatr Transplant. 2015;19(5):E126–9.CrossRefGoogle Scholar
  16. 16.
    Oh J, Schaefer F, Veldmann A, Nowak G, Nowak-Göttl U, Tönshoff B, Kreuz W. Heterozygous prothrombin gene mutation: a new risk factor for early renal allograft thrombosis. Transplantation. 1999;68(4):575–8.CrossRefGoogle Scholar
  17. 17.
    Nagra A, Trompeter RS, Fernando ON, Koffman G, Taylor JD, Lord R, Hutchinson C, O’Sullivan C, Rees L. The effect of heparin on graft thrombosis in pediatric renal allografts. Pediatr Nephrol. 2004;19(5):531–5.CrossRefGoogle Scholar
  18. 18.
    Kranz B, Vester U, Nadalin S, Paul A, Broelsch CE, Hoyer PF. Outcome after kidney transplantation in children with thrombotic risk factors. Pediatr Transplant. 2006;10(7):788–93.CrossRefGoogle Scholar
  19. 19.
    Qu Y, Galvan A, Fuligni AJ, Lieberman MD, Telzer EH. Longitudinal changes in prefrontal cortex activation underlie declines in adolescent risk taking. J Neurosci. 2015;35(32):11308–14.CrossRefGoogle Scholar
  20. 20.
    Maldonado AQ, Tichy EM, Rogers CC, Campara M, Ensor C, Doligalski CT, Gabardi S, Descourouez JL, Doyle IC, Trofe-Clark J. Assessing pharmacologic and nonpharmacologic risks in candidates for kidney transplantation. Am J Health Syst Pharm. 2015;72(10):781–93.CrossRefGoogle Scholar
  21. 21.
    Lunde I, Bremer S, Midtvedt K, Mohebi B, Dahl M, Bergan S, Åsberg A, Christensen H. The influence of CYP3A, PPARA, and POR genetic variants on the pharmacokinetics of tacrolimus and cyclosporine in renal transplant recipients. Eur J Clin Pharmacol. 2014;70(6):685–93.CrossRefGoogle Scholar
  22. 22.
    Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009 Nov;9(Suppl 3):S1–155.Google Scholar
  23. 23.
    Baker RJ, Mark PB, Patel RK, Stevens KK, Palmer N. Renal association clinical practice guideline in post-operative care in the kidney transplant recipient. BMC Nephrol. 2017;18(1):174.CrossRefGoogle Scholar
  24. 24.
    Nevins TE, Nickerson PW, Dew MA. Understanding medication nonadherence after kidney transplant. J Am Soc Nephrol. 2017;28(8):2290–301.CrossRefGoogle Scholar
  25. 25.
    Razonable RR, Humar A. AST infectious diseases community of practice. Cytomegalovirus in solid organ transplantation. Am J Transplant. 2013;13(Suppl 4):93–106.CrossRefGoogle Scholar
  26. 26.
    Le J, Durand CM, Agha I, Brennan DC. Epstein-Barr virus and renal transplantation. Transplant Rev. 2017;31(1):55–60.  https://doi.org/10.1016/j.trre.2016.12.001. Epub 2016 Dec 29CrossRefGoogle Scholar
  27. 27.
    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. Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study. Clin Infect Dis. 2013;56(1):84–92.  https://doi.org/10.1093/cid/cis823. Epub 2012 Oct 5CrossRefPubMedGoogle Scholar
  28. 28.
    Hirsch HH, Brennan DC, Drachenberg CB, Ginevri F, Gordon J, Limaye AP, Mihatsch MJ, Nickeleit V, Ramos E, Randhawa P, Shapiro R, Steiger J, Suthanthiran M, Trofe J. Polyomavirus-associated nephropathy in renal transplantation: interdisciplinary analyses and recommendations. Transplantation. 2005;79(10):1277–86.CrossRefGoogle Scholar
  29. 29.
    Pham PT, Schaenman J, Pham PC. BK virus infection following kidney transplantation: an overview of risk factors, screening strategies, and therapeutic interventions. Curr Opin Organ Transplant. 2014;19(4):401–12.CrossRefGoogle Scholar
  30. 30.
    Sharma AP, Moussa M, Casier S, Rehman F, Filler G, Grimmer J. Intravenous immunoglobulin as rescue therapy for BK virus nephropathy. Pediatr Transplant. 2009;13(1):123–9.CrossRefGoogle Scholar
  31. 31.
    Shah T, Vu D, Naraghi R, Campbell A, Min D. Efficacy of intravenous immunoglobulin in the treatment of persistent BK viremia and BK virus nephropathy in renal transplant recipients. Clin Transpl. 2014:109–16.Google Scholar
  32. 32.
    Hirsch HH, Yakhontova K, Lu M, Manzetti JBK. Polyomavirus replication in renal tubular epithelial cells is inhibited by Sirolimus, but activated by tacrolimus through a pathway involving FKBP-12. Am J Transplant. 2016;16(3):821–32.CrossRefGoogle Scholar
  33. 33.
    Thangaraju S, Gill J, Wright A, Dong J, Rose C, Gill J. Risk factors for BK polyoma virus treatment and association of treatment with kidney transplant failure: insights from a paired kidney analysis. Transplantation. 2016;100(4):854–61.CrossRefGoogle Scholar
  34. 34.
    Mallat SG, Tanios BY, Itani HS, Lotfi T, McMullan C, Gabardi S, Akl EA, Azzi JR. CMV and BKPyV infections in renal transplant recipients receiving an mTOR inhibitor-based regimen versus a CNI-based regimen: a systematic review and meta-analysis of randomized, controlled trials. Clin J Am Soc Nephrol. 2017;12:1321.CrossRefGoogle Scholar
  35. 35.
    Martin SI, Fishman JA, AST Infectious Diseases Community of Practice. Pneumocystis pneumonia in sold organ transplantation. Am J Transplant. 2013;13(Suppl 4):272–9.  https://doi.org/10.1111/ajt.12119.CrossRefPubMedGoogle Scholar
  36. 36.
    Favi E, Spagnoletti G, Salerno MP, Pedroso JA, Romagnoli J, Citterio F. Tacrolimus plus mycophenolate mofetil vs. cyclosporine plus everolimus in deceased donor kidney transplant recipients: three-yr results of a single-center prospective clinical trial. Clin Transpl. 2013;27(4):E359–67.CrossRefGoogle Scholar
  37. 37.
    Ichimaru N, Yamanaka K, Kato T, Kakuta Y, Abe T, Imamura R, Nonomura N, Kaimori JY, Takahara S. Risk factors and incidence for lipid abnormalities in kidney transplant patients. Transplant Proc. 2015;47(3):672–4.CrossRefGoogle Scholar
  38. 38.
    Nogueira JM, Haririan A, Jacobs SC, Cooper M, Weir MR. Cigarette smoking, kidney function, and mortality after live donor kidney transplant. Am J Kidney Dis. 2010;55(5):907–15.CrossRefGoogle Scholar
  39. 39.
    van Gelder T, Silva HT, de Fijter JW, Budde K, Kuypers D, Tyden G, Lohmus A, Sommerer C, Hartmann A, Le Meur Y, Oellerich M, Holt DW, Tönshoff B, Keown P, Campbell S, Mamelok RD. Comparing mycophenolate mofetil regimens for de novo renal transplant recipients: the fixed-dose concentration-controlled trial. Transplantation. 2008;86(8):1043–51.CrossRefGoogle Scholar
  40. 40.
    Gaston RS, Kaplan B, Shah T, Cibrik D, Shaw LM, Angelis M, Mulgaonkar S, Meier-Kriesche HU, Patel D, Bloom RD. Fixed- or controlled-dose mycophenolate mofetil with standard- or reduced-dose calcineurin inhibitors: the Opticept trial. Am J Transplant. 2009;9(7):1607–19.CrossRefGoogle Scholar
  41. 41.
    Filler G, Todorova EK, Bax K, Alvarez-Elías AC, Huang SH, Kobrzynski MC. Minimum mycophenolic acid levels are associated with donor-specific antibody formation. Pediatr Transplant. 2016;20(1):34–8.CrossRefGoogle Scholar
  42. 42.
    Mehta R, Cherikh W, Sood P, Hariharan S. Kidney allograft surveillance biopsy practices across US transplant centers: a UNOS survey. Clin Transpl. 2017;31(5).CrossRefGoogle Scholar
  43. 43.
    Aoun B, Decramer S, Vitkevic R, Wannous H, Bandin F, Azema C, Callard P, Brocheriou I, Ulinski T. Protocol biopsies in pediatric renal transplant recipients on cyclosporine versus tacrolimus-based immunosuppression. Pediatr Nephrol. 2013;28(3):493–8.CrossRefGoogle Scholar
  44. 44.
    Birk PE, Stannard KM, Konrad HB, Blydt-Hansen TD, Ogborn MR, Cheang MS, Gartner JG, Gibson IW. Surveillance biopsies are superior to functional studies for the diagnosis of acute and chronic renal allograft pathology in children. Pediatr Transplant. 2004;8(1):29–38.CrossRefGoogle Scholar
  45. 45.
    Hymes LC, Greenbaum L, Amaral SG, Warshaw BL. Surveillance renal transplant biopsies and subclinical rejection at three months post-transplant in pediatric recipients. Pediatr Transplant. 2007;11(5):536–9.CrossRefGoogle Scholar
  46. 46.
    Birk PE. Surveillance biopsies in children post-kidney transplant. Pediatr Nephrol. 2012;27(5):753–60.CrossRefGoogle Scholar
  47. 47.
    Rose EM, Kennedy SE, Mackie FE. Surveillance biopsies after paediatric kidney transplantation: a review. Pediatr Transplant. 2016;20(6):748–55.CrossRefGoogle Scholar
  48. 48.
    Seikku P, Krogerus L, Jalanko H, Holmberg C. Better renal function with enhanced immunosuppression and protocol biopsies after kidney transplantation in children. Pediatr Transplant. 2005;9(6):754–62.CrossRefGoogle Scholar
  49. 49.
    Kanzelmeyer NK, Ahlenstiel T, Drube J, Froede K, Kreuzer M, Broecker V, Ehrich JH, Melk A, Pape L. Protocol biopsy-driven interventions after pediatric renal transplantation. Pediatr Transplant. 2010;14(8):1012–8.CrossRefGoogle Scholar
  50. 50.
    Roedder S, Sigdel T, Salomonis N, Hsieh S, Dai H, Bestard O, Metes D, Zeevi A, Gritsch A, Cheeseman J, Macedo C, Peddy R, Medeiros M, Vincenti F, Asher N, Salvatierra O, Shapiro R, Kirk A, Reed EF, Sarwal MM. The kSORT assay to detect renal transplant patients at high risk for acute rejection: results of the multicenter AART study. PLoS Med. 2014;11(11):e1001759.CrossRefGoogle Scholar
  51. 51.
    Erpicum P, Hanssen O, Weekers L, Lovinfosse P, Meunier P, Tshibanda L, Krzesinski JM, Hustinx R, Jouret F. Non-invasive approaches in the diagnosis of acute rejection in kidney transplant recipients, part II: omics analyses of urine and blood samples. Clin Kidney J. 2017;10(1):106–15.PubMedGoogle Scholar
  52. 52.
    Nadeau-Fredette AC, Hladunewich M, Hui D, Keunen J, Chan CT. End-stage renal disease and pregnancy. Adv Chronic Kidney Dis. 2013;20(3):246–52.CrossRefGoogle Scholar
  53. 53.
    Yousif ME, Bridson JM, Halawa A. Contraception after kidney transplantation, from myth to reality: a comprehensive review of the current evidence. Exp Clin Transplant. 2016;14(3):252–8.PubMedGoogle Scholar
  54. 54.
    Ashoor I, Aviles D, Pasternak R, Vehaskari VM. Sexually transmitted infections in pediatric renal transplant recipients: time to take notice. Pediatr Transplant. 2015;19(6):584–7.CrossRefGoogle Scholar
  55. 55.
    Centers for Disease Control and Prevention (CDC). U S. Medical eligibility criteria for contraceptive use, 2010. MMWR Recomm Rep. 2010 Jun 18;59(RR-4):1–86.Google Scholar
  56. 56.
    Godfrey EM. Helping clinicians prevent pregnancy among sexually active adolescents: U.S. medical eligibility criteria for contraceptive use and U.S. selected practice recommendations for contraceptive use. J Pediatr Adolesc Gynecol. 2015;28(4):209–14.CrossRefGoogle Scholar
  57. 57.
    Josephson MA, McKay DB. Women and transplantation: fertility, sexuality, pregnancy, contraception. Adv Chronic Kidney Dis. 2013;20(5):433–40.CrossRefGoogle Scholar
  58. 58.
    Khosravi M, Golchai J, Mokhtari G. Muco-cutaneous manifestations in 178 renal transplant recipients. Clin Transpl. 2011;25(3):395–400.CrossRefGoogle Scholar
  59. 59.
    Product Information: Sandimmune(R) oral soft gelatin capsules, oral solution, intravenous injection, cyclosporine oral soft gelatin capsules, oral solution, intravenous injection. East Hanover: Novartis Pharmaceuticals Corporation (per FDA); 2013.Google Scholar
  60. 60.
    Product Information: PROGRAF(R) oral capsules, IV injection, tacrolimus oral capsules, IV injection. Deerfield: Astellas Pharma US (per manufacturer); 2011.Google Scholar
  61. 61.
    Moloney FJ, Keane S, O’Kelly P, Conlon PJ, Murphy GM. The impact of skin disease following renal transplantation on quality of life. Br J Dermatol. 2005;153(3):574–8.CrossRefGoogle Scholar
  62. 62.
    Shahidi S, Moeinzadeh F, Mohammadi M, Gholamrezaei A. Sirolimus-based immunosuppression for treatment of cutaneous warts in kidney transplant recipients. Iran J Kidney Dis. 2011;5(5):351–3.PubMedGoogle Scholar
  63. 63.
    Dharancy S, Catteau B, Mortier L, Boleslawski E, Declerck N, Canva V, Piette F, Mathurin P, Pruvot FR. Conversion to sirolimus: a useful strategy for recalcitrant cutaneous viral warts in liver transplant recipient. Liver Transpl. 2006;12(12):1883–7.CrossRefGoogle Scholar
  64. 64.
    Dobbels F, Decorte A, Roskams A, Van Damme-Lombaerts R. Health-related quality of life, treatment adherence, symptom experience and depression in adolescent renal transplant patients. Pediatr Transplant. 2010;14(2):216–23.CrossRefGoogle Scholar
  65. 65.
    Berney-Martinet S, Key F, Bell L, Lépine S, Clermont MJ, Fombonne E. Psychological profile of adolescents with a kidney transplant. Pediatr Transplant. 2009;13(6):701–10.CrossRefGoogle Scholar
  66. 66.
    Kärrfelt HM, Berg UB. Long-term psychosocial outcome after renal transplantation during childhood. Pediatr Transplant. 2008;12(5):557–62.CrossRefGoogle Scholar
  67. 67.
    Dharnidharka VR, Lamb KE, Zheng J, Schechtman KB, Meier- Kriesche H-U. Across all solid organs, adolescent age recipients have worse transplant organ survival than younger age children: a US national registry analysis. Pediatr Transplant. 2015;19:471–6.CrossRefGoogle Scholar
  68. 68.
    Torkaman M, Khalili-Matin-Zadeh Z, Azizabadi-Farahani M, Moghani-Lankarani M, Assari S, Pourfarziani V, Saadat SH, Kavehmanesh Z, Afshar-Payman S. Outcome of living kidney transplant: pediatric in comparison to adults. Transplant Proc. 2007;39(4):1088–90.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Transplant, Department of SurgeryUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of PediatricsUCSF Benioff Children’s Hospital San Francisco, University of California, San FranciscoSan FranciscoUSA

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