Pediatric transplantation.
Analysis of the OPTN/SRTR database demonstrates that, in 2002, pediatric recipients accounted for 7% of all recipients, while pediatric individuals accounted for 14% of deceased organ donors. For children fortunate enough to receive a transplant, there has been continued improvement in outcomes following all forms of transplantation. Current 1-year graft survival is generally excellent, with survival rates following transplantation in many cases equaling or exceeding those of all other recipients. In renal transplantation, despite excellent early graft survival, there is evidence that long-term graft survival for adolescent recipients is well below that of other recipients. A causative role for noncompliance is possible. While the significant improvements in graft and patient survival are laudable, waiting list mortality remains excessive. Pediatric candidates awaiting liver, intestine, and thoracic transplantation face mortality rates generally greater than those of their adult counterparts. This finding is particularly pronounced in patients aged 5 years and younger. While mortality awaiting transplantation is an important consideration in refining organ allocation strategies, it is important to realize that other issues, in addition to mortality, are critical for children. Consideration of the impact of end-stage organ disease on growth and development is often equally important, both while awaiting and after transplantation.
Magee
John C
JC
Scientific Registry of Transplant Recipients/University of Michigan, Ann Arbor, MI, USA. mageej@umich.edu
Bucuvalas
John C
JC
Farmer
Douglas G
DG
Harmon
William E
WE
Hulbert-Shearon
Tempie E
TE
Mendeloff
Eric N
EN
D017677:Age Distribution; D002648:Child; D016208:Databases, Factual; D016027:Heart Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007422:Intestines / Q000637:transplantation; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data; D014180:Transplantation / Q000706:statistics & numerical data* / Q000639:trends; D014184:Transplantation, Homologous / Q000401:mortality / Q000706:statistics & numerical data; D014850:Waiting Lists