Optimizing the pediatric transplant candidate.

James E Squires, Vikram K Raghu, George V Mazariegos

Journal: Current opinion in organ transplantation 2024;29(1):43-49

PMID: 37823752

Abstract

PURPOSE OF REVIEW

Advances in pediatric transplant parallel those in adult populations; however, there remain critical unique considerations and differences that require specialized knowledge and a specific skill set to optimize care afforded to the pediatric transplant candidate. We introduce general themes regarding optimization of the transplant candidate that are unique to children.

RECENT FINDINGS

The pathologies leading to pediatric organ transplant candidacy differ from adults and a precise understanding of the physiologies and natural histories of such diseases is critical for optimized care. Regardless of etiology, comorbidities including malnutrition, sarcopenia, and developmental delay are seen and often require disease and organ specific approaches to management. Additionally, an understanding of the concepts of developmental immunology and their relevance to transplant is critical.

SUMMARY

When looking to optimize pretransplant care, awareness of the pediatric-specific challenges by the transplant community in addition to organ- and age-specific management strategies enable the best outcomes for children awaiting solid organ transplantation.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Address: Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh.; Thomas E. Starzl Transplantation Institute, Hillman Center for Pediatric Transplantation, Department of Transplant Surgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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