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Post-transplant Medication Challenges

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Challenges in Pediatric Kidney Transplantation

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Abstract

Advancements in the development of potent immunosuppression have paved the way for prolonging allograft survival and improving patient outcomes in pediatric kidney transplantation. As significant improvements have been established in short-term survival over the last few decades, particularly with the introduction of calcineurin inhibitors, the focus remains on the ideal immunosuppressive regimen needed to optimize long-term allograft survival. Avoidance of long-term adverse effects on growth, development, cardiovascular health, along with efforts to minimize risk of infection and malignancy are all driving forces toward adaptation of newer immunosuppression strategies. When compared to adults, children and adolescents are also more susceptible to the unique challenges of medication adherence, polypharmacy, and pharmacokinetic variability. A multidisciplinary approach focused on personalized medicine driven by patient-specific factors and well-designed clinical trials to assess long-term patient and allograft outcomes are needed to guide immunosuppression management in pediatric kidney transplant recipients.

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Authors and Affiliations

  1. Department of Pharmacy, Sidra Medicine, Doha, Qatar

    Nida Siddiqi

  2. Department of Pharmacy, Montefiore Medical Center, Bronx, NY, USA

    Alesa Campbell

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  1. Nida Siddiqi
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  2. Alesa Campbell
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Correspondence to Nida Siddiqi .

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  1. Department of Pediatrics, Division of Pediatric Nephrology, MUSC Shawn Jenkins Children’s Hospital/Medical University of South Carolina, Charleston, SC, USA

    Katherine E. Twombley

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Siddiqi, N., Campbell, A. (2021). Post-transplant Medication Challenges. In: Twombley, K.E. (eds) Challenges in Pediatric Kidney Transplantation . Springer, Cham. https://doi.org/10.1007/978-3-030-74783-1_12

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  • DOI: https://doi.org/10.1007/978-3-030-74783-1_12

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