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Revisiting the Management of Pediatric Kidney Transplants, a Multicenter Analysis Publisher Pubmed



Assadi F1 ; Hooman N2 ; Seyedzadeh A3 ; Azarfar A4 ; Rad EM5 ; Bazargani B6 ; Abassi A6 ; Moghtaderi M6 ; Safaeiasl A7 ; Esfandiar N8 ; Derakhsahn A9 ; Badeli H7 ; Eskandarifar A10 ; Mazaherri M11 Show All Authors
Authors
  1. Assadi F1
  2. Hooman N2
  3. Seyedzadeh A3
  4. Azarfar A4
  5. Rad EM5
  6. Bazargani B6
  7. Abassi A6
  8. Moghtaderi M6
  9. Safaeiasl A7
  10. Esfandiar N8
  11. Derakhsahn A9
  12. Badeli H7
  13. Eskandarifar A10
  14. Mazaherri M11
  15. Sharbaf FG4
Show Affiliations
Authors Affiliations
  1. 1. Department of Pediatrics, Division of Nephrology, Rush University Medical Center, Chicago, IL, United States
  2. 2. Aliasghar Clinical Research Development Center, University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pediatrics, Division of Nephrology, Kermanshah University of Medical Sciences, Kermanshah, Iran
  4. 4. Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  5. 5. Department of Pediatrics, Division of Cardiology, The Children’s Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Pediatric Kidney Diseases Research Center, Guilan University of Medical Science, Rasht, Iran
  8. 8. Department of Pediatrics, Pediatric Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Department of Pediatrics, Section of Nephrology, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  10. 10. Department of Pediatrics, Section of Nephrology, Kurdistan University of Medical Sciences, Sanandaj, Iran
  11. 11. Department of Pediatrics, Section of Nephrology, Semnan University of Medical Sciences, Semnan, Iran

Source: Iranian Journal of Kidney Diseases Published:2022


Abstract

The newest Kidney Disease Improving Global Outcomes (KDIGO) guideline recommendations were investigated mainly for the care of adult kidney transplant recipients, but no guideline exists for the management of pediatric transplant recipients. This review provides update recommendations in the management of pediatric kidney transplantation. Four electronic databases, PubMed, EMBASE, Google Scholar, and Web of Science were searched systematically for the last two decades, using Mesh terms in English language. The Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach was used for grading the quality of the overall evidence and the strength of recommendations for each outcome across the studies. The overall quality of evidence categorized as high (A), moderate (B), low (C), or poor (D). The strength of a recommendation was determined as level 1 (recommended) or level 2 (suggested). The ungraded statements were determined on the basis of common sense to provide general advice. Of the 317 citations which were screened for the evidence review, 62 were included in data extraction. The included studies were randomized controlled trials, prospective cohorts and cross-sectional, descriptive, and review studies. Of the 115 statements, 56 (48.6%) were graded 1 (we recommend), 34 (29.5%) were graded 2 (we suggest), and 25 (21.7%) were ungraded statements. Altogether, only 22 (19.1%) of recommendations reached the “A” or “B” levels of quality of evidence. The pediatric kidney transplant recipients are different from adult recipients regarding the primary kidney diseases, surgical techniques, drug metabolism, adherence to medications, growth and neurocognitive development and immunization needs prior to transplantation. © 2022, Iranian Society of Nephrology. All rights reserved.
Related Docs
1. Graft and Patient Survival Rate Among Iranian Pediatric Recipients of Kidney Transplantation: A Systematic Review and Meta-Analysis, Iranian Journal of Public Health (2022)
2. The Long-Term Outcome of Pediatric Kidney Transplantation in Iran: Results of a 25-Year Single-Center Cohort Study, International Journal of Organ Transplantation Medicine (2017)