title: Renal transplantation in infants.
abstract: Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.
authors.affiliation: Department Pediatric Nephrology and Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 281, Helsinki, 00290, Finland. hannu.jalanko@hus.fi.
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
authors.affiliation: Department of Cardiac and Transplantation Surgery, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Mattila
authors.affiliation: Department Pediatric Nephrology and Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, PO Box 281, Helsinki, 00290, Finland.
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
mesh_terms: D000367:Age Factors; D001835:Body Weight; D002657:Child Development; D046148:Donor Selection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care; D016030:Kidney Transplantation / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Growth; Infant; Infections; Kidney transplantation; Neurocognitive development