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Preparing the pediatric dialysis patient for transplantation

  • M. Sarwal
  • O. SalvatierraJr.

Abstract

Chronic dialysis in children is associated with the morbidity of cardiovascular disease1,2, infection3, nutrition, growth retardation and anemia4. Thus renal transplantation is the preferred definitive modality of treatment for pediatric end-stage renal disease (ESRD). Dialysis can be considered a “bridge” treatment in ESRD patients, supporting the uremic child to eventually benefit from normal renal function and improved quality of life and long-term survival with renal transplantation. Success with surgical and medical outcomes with renal transplantation in children of all ages, beginning as young as infancy, have led to unprecedented graft and patient outcomes in pediatric recipients of renal allografts5. As an example, the young recipient of a large adult-sized kidney transplant from a living donor, now stands to benefit from equivalent or greater graft survival rates than the “gold standard” of human leukocyte antigen (HLA)-identical twin transplantation in adults6, with graft half-lives approaching 30 years. In order to maximize graft and patient survival, there are a number of important considerations prior to transplantation which would include optimizing the overall medical status of the patient, surgical management of the native urinary tract, defining risks, histocompatibility testing and donor selection.

Keywords

Peritoneal Dialysis Human Leukocyte Antigen Polycystic Kidney Disease Posterior Urethral Valve Congenital Nephrotic Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media Dordrecht 2004

Authors and Affiliations

  • M. Sarwal
  • O. SalvatierraJr.

There are no affiliations available

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