Overview of pediatric organ transplantation: current opinion and future perspectives on immunosuppression.
OBJECTIVE
The main aim of this review is to highlight the current advances and significant challenges associated with pediatric organ transplantation, and to explore future perspectives.


RESULTS
Pediatric organ transplantation has greatly improved survival and management of pathological conditions resistant to therapeutic interventions in pediatric populations with end-stage organ failure, and is regarded as a treatment of choice. Advent of immunosuppressive therapies has significantly enhanced the care of these patients and graft survival rates, but the long-term risks of these therapeutic interventions are not well recognized and promote numerous challenges particularly in the pediatric population, due to their off-label use and significant adverse effects that may impact growth, skeletal development, and quality of life. Data regarding the safety of these drugs in children are scare due to the lack of randomized clinical trials in this age group, mainly because of issues related to conducting clinical trials in children and to the small number of pediatric transplantation cases per year.


CONCLUSIONS
It is important to generate registries of pediatric patients with organ transplantation for conducting observational studies, which might provide information for designing future RCTs and new insights toward improving the survival rates and long-term predictors of response.
a1 Hospices Civils de Lyon, EPICIME-CIC 1407 Research Unit, INSERM bFaculté de Médecine Laennec, Université Claude-Bernard Lyon 1 cService de Néphrologie Rhumatologie Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, , Bron, France.
Salma
S
Malik
Behrouz
B
Kassaï
Pierre
P
Cochat
D002648:Child; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D016377:Organ Transplantation; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic