Renal transplantation in childhood is a well established procedure with excellent short-term outcomes. However, waiting times for transplantation are still relatively long if living donation cannot be performed, and long-term outcomes after transplantation have not significantly improved during the last decade.
This review describes alternative modalities to improve donation rates such as en bloc kidney transplantation from young donors, ABO-incompatible transplantation and kidney paired donation. This review also deals with long-term post-transplant morbidities, such as follows: first, medication side-effects (metabolic syndrome, cardiovascular disease) and with the benefits of steroid and calcineurin inhibitor drug minimization; second, the deleterious impact of viral infections and their management and third, chronic antibody-mediated rejection, its therapeutic and prevention possibilities.
Donor shortage and long-term morbidities, after transplantation, are still relevant issues in paediatric renal transplantation medicine. Significant research and efforts have been made to advance the field and create novel approaches for improvement of transplantation rates and post-transplant graft or patient survival. These modalities are to be established in the routine setting.
aDepartment of Paediatrics and Adolescent Medicine, Paediatric Nephrology, Medical University of Vienna, Vienna, Austria
bFirst Department of Paediatrics, Semmelweis University
cNephrological Research Laboratory of the Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
Correspondence to Attila J. Szabo, First Department of Paediatrics, Semmelweis University, Bokay u. 53.H-1083, Budapest, Hungary. Tel: +36 1 3343186 x52635; fax: +36 1 3036077; e-mail: email@example.com