Kidney transplantation in pediatric patients with rheumatologic disorders. Curr Opin Pediatr 2022 Apr 01;34(2):234-240
Date
12/27/2021Pubmed ID
34954727DOI
10.1097/MOP.0000000000001100Scopus ID
2-s2.0-85125553813 (requires institutional sign-in at Scopus site)Abstract
PURPOSE OF REVIEW: Providers caring for children with end-stage kidney disease from rheumatologic conditions face questions such as when to proceed with kidney transplantation, how common is disease recurrence posttransplant, how does recurrent disease impact patient and allograft outcomes, and what approaches are available to prevent and treat recurrent disease. We discuss recent developments and relevant literature that address these questions for the most common rheumatologic disorders that lead to end-stage kidney disease in childhood namely, systemic lupus erythematosus, IgA nephropathy, IgA Vasculitis/Henoch Schoenlein Purpura, and Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis.
RECENT FINDINGS: Recent data suggest that children with IgA nephropathy, IgA vasculitis, and ANCA-associated vasculitis have similar patient and allograft survival to other conditions despite the risk of recurrent disease, yet those with lupus have worse posttransplant patient and allograft outcomes. A period of disease quiescence may be prudent prior to transplantation to decrease the risk of recurrence, which is associated with decreased allograft survival. Data on preventive strategies and treatment options are limited.
SUMMARY: It is recommended that patients with systemic rheumatologic conditions not be excluded from kidney transplantation but that patients be counseled on the risk of potential recurrent disease with its impact on transplant outcomes.
Author List
Cody E, Hooper DKAuthor
Ellen Cody MD Assistant Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anti-Neutrophil Cytoplasmic Antibody-Associated VasculitisArthritis, Rheumatoid
Child
Female
Glomerulonephritis, IGA
Humans
Immunoglobulin A
Kidney Failure, Chronic
Kidney Transplantation
Male
