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Keywords:

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

LaRosa C, Jorge Baluarte H, Meyers KEC. Outcomes in pediatric solid-organ transplantation. Pediatr Transplantation 2011: 15:128–141. © 2010 John Wiley & Sons A/S.

Abstract:  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.