Advertisement

Kidney Transplantation in Children and Adolescents: Surgical Aspects

  • Andrew Perry
  • Jakub Woloszyn
  • Chandrasekar Santhanakrishnan
Chapter

Abstract

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.

Keywords

Donor selection Panel reactive antibody ESRD Vascular anastomosis Immunosuppression Early graft dysfunction 

Notes

Acknowledgment

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.

References

  1. 1.
    Smith JM, Stablein D, Singh A, Harmon W, McDonald RA. Decreased risk of renal allograft thrombosis associated with interleukin-2 receptor antagonists: a report of the NAPRTCS. Am J Transplant Off J Am Soc Transplant Am Soc Transplant Surg. 2006;6(3):585–8.CrossRefGoogle Scholar
  2. 2.
    Smith JM, Martz K, Blydt-Hansen TD. Pediatric kidney transplant practice patterns and outcome benchmarks, 1987–2010: a report of the North American Pediatric Renal Trials and Collaborative Studies. Pediatr Transplant. 2013;17(2):149–57.CrossRefGoogle Scholar
  3. 3.
    North American Pediatric Renal Trials and Collaborative Studies. 2014 annual transplant report. 2014.Google Scholar
  4. 4.
    Ellis D, Gilboa N, Bellinger M, Shapiro R. Renal transplantation in infants and children. In: Shapiro R, Simmons RL, Starzl TE, editors. Renal transplantation. Stamford: Appleton & Lange. 1997, p. 427–69.Google Scholar
  5. 5.
    Moers C, Smits JM, Maathuis MH, Treckmann J, van Gelder F, Napieralski BP, et al. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med. 2009;360(1):7–19.CrossRefGoogle Scholar
  6. 6.
    Lich RHL, Davis LA. Recurrent urosepsis in children. J Urol. 1961;86:554–8.CrossRefGoogle Scholar
  7. 7.
    Gregoir W. The surgical treatment of congenital vesico-ureteral reflux. Acta Chir Belg. 1964;63:431–9.PubMedGoogle Scholar
  8. 8.
    Gregoir W, Vanregemorter G. Congenital vesico-ureteral reflux. Urol Int. 1964;18:122–36.CrossRefGoogle Scholar
  9. 9.
    Politano VA, Leadbetter WF. An operative technique for the correction of vesicoureteral reflux. J Urol. 1958;79(6):932–41.CrossRefGoogle Scholar
  10. 10.
    Taguchi Y, Klauber GT, MacKinnon KJ. Implantation of transplant ureters: a technique. J Urol. 1971;105(2):194–5.CrossRefGoogle Scholar
  11. 11.
    Singh A, Stablein D, Tejani A. Risk factors for vascular thrombosis in pediatric renal transplantation: a special report of the North American Pediatric Renal Transplant Cooperative Study. Transplantation. 1997;63(9):1263–7.CrossRefGoogle Scholar
  12. 12.
    Gulati A, Sarwal MM. Pediatric renal transplantation: an overview and update. Curr Opin Pediatr. 2010;22(2):189–96.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andrew Perry
    • 1
  • Jakub Woloszyn
    • 1
  • Chandrasekar Santhanakrishnan
    • 2
  1. 1.Department of SurgeryUniversity of California, DavisSacramentoUSA
  2. 2.Department of Surgery, Division of Transplant SurgeryUniversity of California, DavisSacramentoUSA

Personalised recommendations