Kidney Transplantation in Children and Adolescents: Surgical Aspects
Pediatric kidney transplantation has become highly successful in the modern era and is the treatment of choice for children with end-stage renal disease (ESRD). Achieving successful surgical outcomes requires a methodical and multidisciplinary approach, beginning with a thorough preoperative evaluation. There are various anatomical and physiological considerations unique to children with chronic kidney disease that necessitates a nuanced surgical approach. In the preoperative phase, addressing underlying urological abnormalities and native kidney disease can be crucial to maximizing graft longevity and survival. Additionally, an individualized approach to surgical technique and fluid management during the operation is critical in preventing technical complications. Lastly, the risk of vascular and urologic complications is higher in the pediatric transplant population. A prompt diagnostic evaluation of early graft dysfunction is crucial to ensuring successful outcomes.
KeywordsDonor selection Panel reactive antibody ESRD Vascular anastomosis Immunosuppression Early graft dysfunction
This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.
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