Renal transplantation in pediatric recipients: Considerations and preoperative assessment strategies

• Published in: Actas urológicas españolas (English ed.) 2023-07, Vol.47 (6), p.351-359
• Main Authors: Bañuelos Marco, B., Dönmez, M.I., Geppert, T., Prudhomme, T., Campi, R., Mesnard, B., Hevia, V., Boissier, R., Pecoraro, A., Territo, A.
• Format: Article
• Language: English
• Subjects: Adult; Assessment; Child; Children; Evaluación; Humans; Infant; Kidney; Kidney Transplantation - methods; Niños; Pediatric; Pediátrico; Preoperative; Preoperatorio; Renal transplantation; Reproducibility of Results; Review; Revisión; Riñón; Trasplante renal
• ISSN: 2173-5786; 2173-5786
• DOI: 10.1016/j.acuroe.2023.03.002

Renal transplantation in the pediatric population differs from adults in many aspects. This review will focus on the unique issues of the pediatric recipient. A narrative review on the scarce literature regarding preoperative evaluation before kidney transplantation of the paediatric recipient with an educational focus was conducted. The literature search allowed for identification of publications in English from January 2000 to October 2022. Published studies were identified by searching the following electronic databases: PubMed (MEDLINE), WHO/UNAIDS, Google-Scholar, Semantic-Scholar and Research Gate. For efficiency and reliability, recent randomized controlled trials, meta-analyses, high quality systematic reviews and large well-designed studies were used if available. Internet searches were conducted for other relevant information (definitions, policies or guidelines). Management of congenital urogenital anomalies and lower urinary tract dysfunction along with optimal pediatric urological preoperative assessment for renal transplantation in children is addressed in the light of the available literature. Furthermore, particular considerations including pre-emptive transplantation, transplantation of an adult-size kidney into an infant or small child is discussed. Outcomes of RT in children have shown progressive improvement over the past 15 years. Transplantation with living related donor gives the best results and pre-emptive transplantation provides with benefits of avoiding dialysis. Surgical and medical considerations in both the pre-transplant and post-transplant management of the pediatric kidney recipient are extremely crucial in order to achieve better short and long-term results. El trasplante renal en la población pediátrica difiere del trasplante en adultos en muchos aspectos. Esta revisión se centrará en los aspectos exclusivos del receptor pediátrico. Se realizó una revisión narrativa de la escasa literatura existente sobre la evaluación preoperatoria del trasplante renal en receptor pediátrico con un enfoque educativo. La búsqueda bibliográfica permitió identificar publicaciones en inglés entre enero de 2000 y octubre de 2022. Los estudios publicados se identificaron mediante búsquedas en las siguientes bases de datos electrónicas: PubMed (MEDLINE), WHO/UNAIDS, Google-Scholar, Semantic-Scholar y Research Gate. En aras de eficacia y fiabilidad, se utilizaron ensayos controlados aleatorizados, metaanálisis, revisiones sistemáticas de alta c