دورية أكاديمية
Progress in pediatric kidney transplantation.
| العنوان: | Progress in pediatric kidney transplantation. |
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| المؤلفون: | Filler G; Department of Paediatrics, University of Western Ontario, London, Ontario, Canada. guido.filler@lhsc.on.ca, Huang SH |
| المصدر: | Therapeutic drug monitoring [Ther Drug Monit] 2010 Jun; Vol. 32 (3), pp. 250-2. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7909660 Publication Model: Print Cited Medium: Internet ISSN: 1536-3694 (Electronic) Linking ISSN: 01634356 NLM ISO Abbreviation: Ther Drug Monit Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: [New York] Raven Press. |
| مواضيع طبية MeSH: | Child*, Graft Rejection/*prevention & control , Immunosuppressive Agents/*therapeutic use , Kidney Transplantation/*immunology , Mycophenolic Acid/*therapeutic use, Humans ; Hypertension/prevention & control ; Immunosuppression Therapy ; Kidney Failure, Chronic ; Reperfusion Injury |
| مستخلص: | This review summarizes the focus shift from ischemia-reperfusion injury and avoidance of rejection to long-term outcome after pediatric renal transplantation over the past decade. Although there has been excellent 1-year graft and patient survival, low rejection rates can be achieved with modern immunosuppression after pediatric renal transplantation, and patient survival is improved substantially in comparison with dialysis, pediatric renal transplant recipients experience a high prevalence of infections, malignancies, medication side effects, nonadherence, and, most importantly, cardiovascular morbidity and mortality. Additional challenges occur because of a high prevalence of obesity after transplantation and vascular calcifications. There is also in an underappreciation of chronic kidney disease (CKD) in transplant recipients. The etiology of CKD is multifactorial and can affect graft and patient survival. The rigors of treatment for CKD are less compared with CKD in nontransplant recipients. Almost all immunosuppressive drugs are implicated with a risk of hypertension, hyperlipidemia, and diabetogenicity, all of which contribute to cardiovascular morbidity. Corticosteroids exhibit the most substantial risk and also stunt growth. Effective new treatment protocols such as the recent European Tacrolimus and WIthdrawal of STeroids (TWIST) study with rapid steroid withdrawal after 5 days provide promising results without increasing the rejection risk. The shift in focus on long-term complications allows for improved graft outcome. Side effects of immunosuppressive medications require continued attention to further improve long-term outcomes. |
| Number of References: | 24 |
| المشرفين على المادة: | 0 (Immunosuppressive Agents) HU9DX48N0T (Mycophenolic Acid) |
| تواريخ الأحداث: | Date Created: 20100501 Date Completed: 20100915 Latest Revision: 20211203 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1097/FTD.0b013e3181dda53d |
| PMID: | 20431507 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1536-3694 |
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| DOI: | 10.1097/FTD.0b013e3181dda53d |