P. Stephen Almond
Transplantation is the optimal renal replacement therapy for infants and children with end-stage renal disease (ESRD). Compared to dialysis, a successful transplant at any age improves survival, allows for more normal growth and development, and provides an excellent quality of life. In large measure, these data are from living related (LR) recipients on cyclosporine (CsA) based immunosuppression. This chapter will review pediatric renal transplantation and the impact of these factors on outcome.
Pediatric renal transplant data are available from three sources. In 1987, North American centers agreed to pool pediatric data in the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). Currently, there are 135 participating centers. These data are published periodically and found by searching the title word "NAPRTCS". In May 1988, the United States Renal Data System (USRDS) was created to "collect and analyze information on the incidence, prevalence, morbidity, and mortality of ESRD in the United States". Since then the USRDS has published annual reports that are available by request or on line at www.med.umich.edu/usrds/. Finally, single center reports from large pediatric transplant centers are in the medical literature.
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