Standard Maintenance Protocols Posttransplant: Follow-Up Visits, Immunizations, Sick Child Calls, etc.

  • Louise M. Flynn
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)


Long-term survival for pediatric recipients of solid organ transplants has improved greatly over the years. Provision of quality care is needed to help ensure patient and graft survival. Because of the complexities of transplantation, it is crucial for primary care providers to work closely with transplant teams. As length of time from transplant increases, more of the general care of pediatric recipients will be coordinated through the primary care providers. The following chapter reviews some of the nuances necessary to consider when caring for this population.


Growth and development Neurocognitive Psychosocial Infection Cytomegalovirus Epstein-Barr virus BK polyomavirus Immunizations Immunosuppression Adolescent health Transitioning 


  1. Alexander BD, Fishman JA (2017) Prophylaxis of infections in solid organ transplantation. In UpToDate. Available via UpToDate. Accessed 9 Feb 2017
  2. Brown DP, Chapman JR (2016) Care of transplant recipients in primary practice. Transplantation 100(3):474–476CrossRefPubMedGoogle Scholar
  3. Costanzo MR, Taylor D, Hunt S et al (2010) The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant 29:914–956CrossRefPubMedGoogle Scholar
  4. Danziger-Isakov L, Kumar D et al (2013) Vaccination in solid organ transplantation. Am J Transplant 13:311–317CrossRefPubMedGoogle Scholar
  5. DeAngelis M, Martin K, Williams A, Kosmach-Park B (2010) Most commonly asked questions from parents of pediatric transplant recipients. Pediatr Clin N Am 57(2):611–622CrossRefGoogle Scholar
  6. Feng S (2008) Long-term management of immunosuppression after pediatric liver transplantation: is minimization or withdrawal desirable and/or possible? Curr Opin Organ Transplant 13(5):506–512CrossRefPubMedPubMedCentralGoogle Scholar
  7. Gold A, Martin K, Breckbill K, Avitzur Y, Kaufman M (2015) Transition to adult care in pediatric solid-organ transplant: development of a practice guideline. Progress n Transplantation 25(2):131–138CrossRefGoogle Scholar
  8. Hirsch HH, Randhawa P (2013) BK polyomavirus in solid organ transplantation. Am J Transplant 13:179–188CrossRefPubMedGoogle Scholar
  9. Kasiske BL, Zeier MG, Chapman JR, Craig JC, Ekberg H, Garvey CA, Green MD, Jhs V, Josepson MA, Kiberd BA, Kreis HA, McDonald RA, Newmann JM, Obrador GT, Voncenti FG, Cheun M, Earley A, Raman G, Abargia S, Wagner M, Balk EM (2010) KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary. Kidney Int 77:299–311CrossRefPubMedGoogle Scholar
  10. Kawano Y, Suzuki M, Kawada J, Kimura H, Kamei H, Ohnishi Y, Ono Y, Uchida H, Ogura Y (2015) Effectiveness and safety of immunization with live-attenuated and inactivated vaccines for pediatric liver transplantation recipients. Vaccine 3(12):1440–1445CrossRefGoogle Scholar
  11. Kelly DA, Bucuvalas JC, Alonso EM, Karpen SJ, Allen U, Green M, Farmer D, Shemesh E, McDonald R (2013) Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guidelines by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver Transpl 19:798–825CrossRefPubMedGoogle Scholar
  12. Kim JJ, Marks SD (2014) Long-term outcomes of children after solid organ transplantation. Clinics.
  13. Martin SI, Fishman JA (2013) Pneumocystis pneumonia in solid organ transplantation. Amercian. Journal of Transplantation 13:272–279CrossRefGoogle Scholar
  14. McDonald RA (2016) Outcomes of renal transplantation in children. In UpToDate. Available via UpToDate. Accessed 7 Sept 2016
  15. McGuire BM, Rosenthal P, Brown CC, Busch AM, Calcatera SM, Claria RS, Hunt NK, Korenblat KM, Mazariegos GV, Moonka D, Orloff SL, Perry DK, Rosen CB, Scott DL, Sudan DL (2009) Long-term management of the liver transplant patient: recommendations for the primary care doctor. Am J Transplant 9:1988–2003CrossRefPubMedGoogle Scholar
  16. Perito ER, Lau A, Rhee S, Roberts JP, Rosenthal P (2012) Posttransplant metabolic syndrome in children and adolescents after liver transplantation: a systematic review. Liver Transpl 18:1009–1028CrossRefPubMedCentralGoogle Scholar
  17. Pfister ED, McLin VA, Hierro L, Tizzard SA, Baumann U (2015) Current state and prospects in managing liver transplanted children. Clin Res Hepatol Gastroenterol 39(3):292–295CrossRefPubMedGoogle Scholar
  18. Posfay-Barbe KM, Pittt LF, Sottas C, Grillet S, Wildhaber BE, Rodriguez M, Kaiser L, Belli DC, McLin VA, Siegrist CA (2012) Varicella-zoster immunization in pediatric liver transplants recipients: safe and immunogenic. American journal of transplantation 12:2974–2985CrossRefPubMedGoogle Scholar
  19. Razonable RR, Humar A (2013) Cytomegalovirus in solid organ transplantation. Am J Transplant 13:93–106CrossRefPubMedGoogle Scholar
  20. Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, Bousvaros A, Dhanireddy S, Sung L, Keyserling H, Kang I (2014) 2013 IDSA clinical practice guidelines for vaccination of the immunocompromised host. Clin Infect Dis 58(3):309–318CrossRefPubMedGoogle Scholar
  21. Sagar N, Leithead JA, Lloyd C, Smith M, Gunson BK, Adams DH, Kelly D, Ferguson JW (2015) Pediatric liver transplant recipients who undergo transfer to the adult healthcare service have good long-term outcomes. Am J Transplant 15:1864–1873CrossRefPubMedGoogle Scholar
  22. Shinjoh M, Hoshino K, Takahashi T, Nakayama T (2015) Updated data on effective and safe immunizations with live-attenuated vaccines for children after living donor liver transplantation. Vaccine 33(5):701–707CrossRefPubMedGoogle Scholar
  23. Subramanian AK (2011) Antimicrobial prophylaxis regimens following transplantation. Current Opinion in Infectious Disease 24(4):344–349CrossRefGoogle Scholar
  24. Sudan D (2014) The current state of intestine transplantation: indications techniques, outcomes and challenges. Am J Transplant 14:1976–1984CrossRefPubMedGoogle Scholar
  25. Verolet CM, Posfay-Barbe KM (2015) Live virus vaccines in transplantation: friend or foe? Curr Infect Dis Rep 17:14. CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Alfred I. duPont Hospital for ChildrenWilmingtonUSA

Section editors and affiliations

  • Deborah M Consolini
    • 1
  1. 1.Nemours/Alfred I. duPont Hospital for ChildrenWilmingtonUSA

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