Thoughts about kidney homotransplantation in children

Riley, Conrad M.

doi:10.1016/s0022-3476(64)80181-5

Cited by 41 publications

(10 citation statements)

References 3 publications

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“…[9][10][11][12][13][14] With the use of cyclosporine, high-dose prednisone therapy usually has been unnecessary. Survival of both the patient and graft, as well as quality of life, have been improved with transplantation of kidneys and livers in adults 2 ; similar improvement has been predicted for children.…”

Section: Commentmentioning

confidence: 99%

Linear Growth Following Pediatric Liver Transplantation

Urbach¹

1987

Arch Pediatr Adolesc Med

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Section: Commentmentioning

confidence: 99%

Linear Growth Following Pediatric Liver Transplantation

Urbach¹

1987

Arch Pediatr Adolesc Med

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“…If the child needs to undergo RRT then he/she is subjected to a number of potentially painful procedures as well as growth, educational, psychological and social restraints [2,3]. With dependence on haemodialysis machines initially designed for adults and the lack of transplantation experience it was hardly surprising that many doubted the wisdom of offering RRT to children in the 1960s and 1970s [4]. However, the increasing experience of specialist units and the advent of chronic peritoneal dialysis in the 1980s enabled children to be treated successfully at home and at some distance from tertiary paediatric renal centres [5,6].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial support for children and families requiring renal replacement therapy

Watson

2013

Pediatr Nephrol

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Chronic kidney disease (CKD) and the need for renal replacement therapy (RRT) can place a great strain on the child and family. As well as the medical and nutritional prescription, each child and family requires an individual psychosocial prescription that requires input from multiprofessional team members. The information needs of each child and family need to be constantly evaluated as well as the choice of therapy in relation to social, psychological and economic factors. Many tertiary units lack adequate "time" to deliver such assessments and coordinate the support and respite care for those on long-term dialysis, especially when significant numbers of children are now accepted onto RRT programmes with co-morbidities. National and international standards are needed for the staffing of comprehensive tertiary paediatric renal units as well as studies evaluating supportive care to families.

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“…11 However, the first report of consistent success in treating infants and children 4,12 was promptly confirmed, [13][14][15][16] although acceptable results were obtained only with consanguineous donors. A number of special pediatric transplantation centers were established, [17][18][19][20] at which there usually has been a major effort to find genetically related donors.…”

Section: Discussionmentioning

confidence: 99%

Liver and kidney transplantation in children receiving cyclosporin A and steroids

Starzl

Iwatsuki

Malatack

et al. 1982

The Journal of Pediatrics

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The new immunosuppressive agent, cyclosporin A, was used with low doses of steroids to treat eight patients undergoing hepatic transplantation and three patients undergoing cadaveric renal transplantation. Seven of the eight liver recipients are well, including one who was given two livers. The three kidney recipients, who had developed cytotoxic antibodies after previously rejecting grafts with conventional immunosuppressive therapy, have had good results despite conditions which usually preclude attempts at transplantation. The ability to control rejection effectively and safely without chronic high-dose steroid therapy may make the described therapeutic regimen valuable for pediatric recipients of whole organs.Cadaveric organ transplantation in infants and children has been an unreliable and morbidity-laden undertaking. The ability to control rejection has been unpredictable with conventional immunosuppressive therapy including azathioprine and prednisone with or without anti-lymphocyte globulin. Even with "success" the frequent need for high-dose steroid therapy has all too often degraded the quality of post-transplantation life.We report here an alternative method of immunosuppression with cyclosporin A and low doses of steroids that has been used in eight liver and three cadaveric kidney recipients who have been followed for 3½ months to 1⅓ years. Although the experience is small and the follow-up periods short, the results have made us believe that transplantation of a variety of organs will become a practical reality in larger numbers of pediatric health care centers. METHODS Case materialLiver recipients-The eight patients were 2⅙ to 16 years of age (Table I). Four had biliary atresia; of these, three had had one or more previous attempts at porticoenterostomy (Kasai procedure), and the earlier operations made transplantation difficult. Other diagnoses are shown in Table I.Donor selection was random in respect to the HLA A, B and D loci. Matches of the four antigens of the A and B loci averaged 1.0 ± 0.7 (SD), range 0 to 2. Two DR matches were present in one case, one match existed in two cases, and no matches were present in the other six donor-recipient combinations.

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Thoughts about kidney homotransplantation in children

Cited by 41 publications

References 3 publications

Linear Growth Following Pediatric Liver Transplantation

Linear Growth Following Pediatric Liver Transplantation

Psychosocial support for children and families requiring renal replacement therapy

Liver and kidney transplantation in children receiving cyclosporin A and steroids

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