Immunosuppression in the pediatric transplant recipient |
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| Affiliation: | 1. Division of Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences, United States;2. Division of Biostatistics, Department of Pediatrics, University of Arkansas for Medical Sciences, United States;3. Division of Neonatology, Department of Pediatrics, University of Arkansas for Medical Sciences, United States;1. Department of Clinical Service, Oslo University Hospital, Oslo, Norway;2. Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway;3. Department of Psychosomatic Medicine, Oslo University Hospital, Oslo, Norway;4. Department of Research and Education (clinical neuroscience) Oslo University Hospital, Oslo, Norway;5. Department of Pulmonary Medicine, Akershus University Hospital, Nordbyhagen, Norway;6. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;7. Department of Psychiatry, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, USA;8. Oslo Akershus University College of Applied Sciences, Faculty of Health Sciences, Oslo, Norway |
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| Abstract: | The field of pediatric solid-organ transplantation has significantly evolved since its beginnings in the early 20th century. As advancements have led to the development of innovative surgical techniques and novel medication regimens, transplantation has now become a routine practice leading to an increase in the rates of organ recipients worldwide.The care of pediatric solid-organ transplant recipients differs from adults in several areas not only due to technically challenging surgeries, but mostly due to the complexity of their immunosuppression management. Although there is large variation of pediatric immunosuppression regimens worldwide, the use of calcineurin inhibitors, either tacrolimus or cyclosporine, still forms the backbone of immunosuppression regimens after solid-organ transplantation. Both medications are relatively well tolerated but are known to have long-term side effects, especially nephrotoxicity and neurotoxicity. The goal of care in long-term pediatric survivors of solid-organ transplant now aims to safely minimize exposure to immunosuppression and to achieve long-term graft tolerance. |
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| Keywords: | Pediatric solid-organ transplant Pediatric immunosuppression |
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