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Immunosuppression in renal transplantation in children

Author
Ruth A McDonald, MD
Section Editor
Patrick Niaudet, MD
Deputy Editor
Melanie S Kim, MD

INTRODUCTION

The major advance allowing prolonged allograft survival in pediatric renal transplantation has been the use of immunosuppressive drugs that down-regulate the immune response. The goal remains to find the best combination of immunosuppressive agents that optimizes allograft survival by preventing acute rejection while limiting drug toxicities. Although data from adult renal transplantation trials are used to help guide management decisions in pediatric patients, immunosuppression often must be modified because of the unique clinical effects of some of these agents in children, including their impact on growth and development.

An overview of immunosuppression regimens used in children undergoing renal transplantation will be reviewed here. Additional issues concerning transplantation in children as well as detailed discussions of immunosuppressive issues in renal transplantation common to both children and adults are presented separately. (See "General principles of renal transplantation in children" and "Outcomes of renal transplantation in children" and "Maintenance immunosuppressive therapy in renal transplantation in adults" and "Induction immunosuppressive therapy in renal transplantation in adults".)

OVERVIEW

The goal of immunosuppression is to prevent acute rejection while minimizing drug side effects. In children who undergo renal transplantation, immunosuppression is divided into the three following categories:

Induction therapy – Intensive immunosuppression administered during the perioperative period to prevent acute rejection

Maintenance therapy – Immunosuppressive therapy to prevent acute rejection after the perioperative period

                                   

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Literature review current through: Nov 2016. | This topic last updated: Fri Feb 05 00:00:00 GMT+00:00 2016.
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