Immunologic Response of the Child to Short- and Long-Term Immunosuppression

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


Solid organ transplantation has become a proven and accepted therapy in pediatric patients with organ failure that is not only lifesaving but also greatly contributes to a better quality of life in organ recipients. This development was possible because of a remarkable expansion in the available repertoire of immunosuppressive medications. Over the past 30 years, however, despite considerable improvement in short-term outcomes, long-term allograft survival has only minimally improved. Chronic allograft dysfunction is the leading cause of allograft loss in pediatric organ transplant recipients. In addition, the consequences of the long-term use of immunosuppressive medications can be severe and include increased susceptibility to infection, drug toxicities, and the development of comorbid conditions such as chronic kidney disease, cardiovascular disease, and cancer. This chapter will review current immunosuppressive strategies used in solid organ transplantation with a particular focus on the immunologic response of pediatric patients to both short- and long-term immunosuppression strategies. Further research will hopefully provide us with newer strategies that promote immunologic tolerance of the transplanted organ without the severe side effects and with improved long-term allograft survival.


Immunosuppression Corticosteroids Calcineurin inhibitor Antiproliferatives mTOR inhibitor Antibody therapies Acute cellular rejection Antibody mediated rejection Chronic allograft dysfunction Nephrotoxicity Posttransplant lymphoproliferative disorder Nonadherence Tolerance 



acute cellular rejection


Antibody-mediated rejection


Antigen-presenting cell


Anti-thymocyte globulin


Allograft vasculopathy


Chronic allograft dysfunction


Chronic kidney disease




Calcineurin inhibitor


Donor-specific antibodies


Epstein-Barr virus


End-stage kidney disease


FK506-binding protein12


Hepatic artery thrombosis




Intravenous immune globulin


Mycophenolate mofetil




Magnetic resonance imaging


Mammalian targets of rapamycin


Nuclear factor of activated T-cells


Nuclear factor kappa-light-chain-enhancer of activated B cells


New onset diabetes after transplantation




Posterior reversible encephalopathy syndrome


Posttransplant lymphoproliferative disease


Solid organ transplantation


Thiopurine S-methyltransferase


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Nemours/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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