Kidney Transplantation in Pediatric Recipients With Mental Retardation: Clinical Results of a Multicenter Experience in Japan

Update on Ethical Issues in Pediatric Dialysis: Has Pediatric Dialysis Become Morally Obligatory?

“…In contrast, Neu et al, reporting data from the International Pediatric Peritoneal Dialysis Network, demonstrated a higher hospitalization rate and lower 4-year survival rate in patients on peritoneal dialysis with at least one comorbidity (73% versus 90%, respectively) (6). Other studies have suggested renal transplantation is a therapeutic option in this population, with excellent graft survival and reported improvement in quality of life (7,8).…”

“…Recent controversies have suggested that traditional exclusion criteria may lack a strong ethical support and instead have reflected societal values of certain traits (such as intelligence) (10,17). Furthermore, newer research has demonstrated excellent outcomes in this population, including perceived improvement in quality of life (7,8). Practically, the number of children who could be candidates for dialysis but could not be future candidates for transplantation is very small.…”

Consideration of children with intellectual disability as candidates for solid organ transplantation—A practice in evolution

“…A summary of outcome studies from small case series of children with intellectual disabilities who received solid organ transplants can be found in Table . In one of the largest series, Ohta and colleagues reported the outcomes of 25 “multiply handicapped” kidney transplant recipients including 13 with IQ < 35 at eight Japanese centers over 7 years . The authors reported excellent patient and graft survival and also demonstrated improvement in both parent QoL and parent‐proxy recipient QoL following transplant .…”

“…In one of the largest series, Ohta and colleagues reported the outcomes of 25 “multiply handicapped” kidney transplant recipients including 13 with IQ < 35 at eight Japanese centers over 7 years . The authors reported excellent patient and graft survival and also demonstrated improvement in both parent QoL and parent‐proxy recipient QoL following transplant . Beginning in 2008, the SRTR began collecting information on cognitive development, academic level, and academic progress for pediatric transplant recipients.…”

Re-evaluating the Recipient Criteria for Organ Transplants

“…5 The grafts were all functioning at a mean follow-up of more than 3 years and "…all persons providing primary support for patients were satisfi ed with the [kidney transplant] and believed that quality of life was improved in both transplant recipients and themselves. "…”