Developing a framework for evaluating kidney transplantation candidacy in children with multiple comorbidities.
Children with multiple comorbidities, including neurodevelopmental delay, can develop end-stage kidney disease (ESKD). When and if these children should be eligible for kidney transplantation is an area of debate within the pediatric nephrology community and the public. Discussions focus on expected survival and quality of life posttransplant, as well as resource allocation decisions, as donor kidneys remain a limited resource. This paper focuses on the evidence available regarding outcomes in this population and the ethical issues that should be considered. The authors offer a framework for transplant teams evaluating children with comorbidities for kidney transplant, focusing on the benefits and burdens that transplantation can be expected to achieve.
Section of Nephrology, Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba and Health Sciences Centre Children's Hospital, FE009 840 Sherbrook St., Winnipeg, Manitoba, Canada, R3M 0P1, agoldberg@hsc.mb.ca.
Aviva M
AM
Goldberg
Sandra
S
Amaral
Asha
A
Moudgil
D002648:Child; D015897:Comorbidity; D006801:Humans; D016030:Kidney Transplantation; D018579:Patient Selection; D066027:Transplant Recipients