Pediatric Transplantation

When pediatric kidney transplant recipients were compared based on the achievement (or not) of a CD3+ T-cell count < 25 cells/mm³ following rabbit anti-thymocyte globulin induction, there were no differences in infectious or graft outcomes by 12-months post-transplant.

This study compares pediatric liver transplant outcomes between living donor liver transplantation (LDLT) and donation after brain death (DBD), highlighting the impact of cold ischemia time, blood transfusions, and recipient characteristics on postoperative complications and survival rates.

Young adults who initiate dialysis before 18 years old are disadvantaged by current OPTN waitlist and organ allocation policies for kidney transplantation. Compared to adolescents and other young adults, these patients spend the longest time on dialysis, have the highest incidence of waitlist removal without transplant, and have the worst graft survival after kidney transplantation.

In a review of a national database spanning the past three decades, researchers investigated delayed graft function (DGF) in pediatric recipients of deceased donor kidney transplants. This study found that DGF was associated with reduced survival after cases and controls were matched across various donor, recipient, and transplant factors.

Pediatric KTRs may be safely treated with alemtuzumab induction without increased acute rejection, delayed graft function, graft loss, or patient mortality, but with decreased CMV infection and 1 and 5 years hospitalization rates. Steroid maintenance is associated with decreased 5 years hospitalization and PTLD, but increased mortality.

Pediatric kidney transplant recipients given two doses of alemtuzumab induction immunosuppression, with steroid-free maintenance immunosuppression, had a ten-year living-donor graft survival of 86.5% and a deceased donor graft survival of 57.7%. The incidence of viral infections was similar to that reported in other cohorts, and growth improved after transplant.

This single-center retrospective study aimed to compare the efficacy and safety of basiliximab versus a single 3 mg/kg dose of anti-thymocyte globulin (r-ATG) induction therapy in pediatric kidney transplant recipients. The r-ATG induction therapy was associated with lower incidence of acute rejection and similar safety profile compared to basiliximab.

Kidney Paired Donation provides increased access to high quality living donor organs with possible immunologic, size, age, and logistic advantages for pediatric patients and should be encouraged.

The impact of weight at the time of kidney transplantation and how pediatric kidney transplant outcomes have changed over 25-years for recipients weighing <10 kg.

Kidney transplantation before 2 years of age is associated with a survival benefit compared with remaining on the waitlist until older than age 2 years.