title: Outcomes in pediatric solid-organ transplantation.
abstract: LaR 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.
authors.affiliation: Division of Nephrology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: LaRosa
authors.forename: H Jorge
authors.initials: HJ
authors.lastname: Baluarte
authors.forename: Kevin E C
authors.initials: KE
authors.lastname: Meyers
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007422:Intestines / Q000637:transplantation; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D016040:Lung Transplantation; D008297:Male; D016377:Organ Transplantation / Q000009:adverse effects* / Q000401:mortality*; D010372:Pediatrics; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D014181:Transplantation Immunology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents