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Outcomes in pediatric solid-organ transplantation

Journal

PEDIATRIC TRANSPLANTATION
Volume 15, Issue 2, Pages 128-141

Publisher

WILEY
DOI: 10.1111/j.1399-3046.2010.01434.x

Keywords

pediatric; adolescent; transplantation; outcomes; growth; renal; cardiovascular; infection; malignancy; steroids; psychosocial; cognitive; adherence

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Pediatric solid-organ transplantation is an increasingly successful treatment for organ failure. Five-and 10-yr patient survival rates have dramatically improved over the last couple of decades, and currently, over 80% of pediatric patients survive into adolescence and young adulthood. Waiting list mortality has been a concern for liver, heart, and intestinal transplantation, illustrating the importance of transplant as a life-saving therapy. Unfortunately, the success of pediatric transplantation comes at the cost of long-term or late complications that arise as a result of allograft rejection or injury, immunosuppression-related morbidity, or both. As transplant recipients enter adolescence treatment, non-adherence becomes a significant issue, and the medical and psychosocial impacts transition to adulthood not only with regard to healthcare but also in terms of functional outcomes, economic potential, and overall QoL. This review addresses the clinical and psychosocial challenges encountered by pediatric transplant recipients in the current era. A better understanding of pediatric transplant outcomes and adult morbidity and mortality requires further ongoing assessment.

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