Revisiting the Management of Pediatric Kidney Transplants, A Multicenter Analysis

Authors

  • Farahnak Assadi Department of Pediatrics, Division of Nephrology, Rush University Medical Center, Chicago Illinois, USA
  • Nakysa Hooman Aliasghar Clinical Research Development Center, University of Medical Sciences, Tehran, Iran
  • Abdolhassan Seyedzadeh Department of Pediatrics, Division of Nephrology, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Anoush Azarfar Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Elaheh Malakan Rad Department of Pediatrics, Division of Cardiology, The Children’s Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
  • Behnaz Bazargani Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  • Arash Abasi Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  • Mastaneh Moghtaderi Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  • Afshin Safaeiasl Pediatric Kidney Diseases Research Center, Guilan University of Medical Science, Rasht, Iran
  • Nasrin Esfandiar Department of Pediatrics, Pediatric Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Ali Derakhsan Department of Pediatrics, Section of Nephrology, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Hamidreza Badeli Pediatric Kidney Diseases Research Center, Guilan University of Medical Science, Rasht, Iran
  • Alireza Eskandarifar Department of Pediatrics, Section of Nephrology, Kurdistan University of Medical Sciences, Sanandaj, Iran
  • Mojgan Mazaheri Department of Pediatrics, Section of Nephrology, Semnan University of Medical Sciences, Semnan, Iran
  • Fatemeh Ghane Sharbaf Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

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.

 

DOI: 10.52547/ijkd.7179

Author Biographies

  • Farahnak Assadi, Department of Pediatrics, Division of Nephrology, Rush University Medical Center, Chicago Illinois, USA

    . Farahnak Assadi, Department of Pediatrics, Division of Nephrology, Rush

    University Medical Center, Chicago Illinois, USA. 0000-0001-5202-036x,

    fassadi@rush.edu

  • Nakysa Hooman, Aliasghar Clinical Research Development Center, University of Medical Sciences, Tehran, Iran

    Nakysa Hooman, 2Aliasghar Clinical Research Development Center, Iran

     University of Medical Sciences, Tehran, Iran 0000-0002-8494-947x,

    hooman.n@iums.ac.ir

  • Abdolhassan Seyedzadeh, Department of Pediatrics, Division of Nephrology, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Abdolhassan Seyedzadeh, Department of Pediatrics, Division of

     Nephrology, Kermanshah University of Medical Sciences, Kermanshah, Iran

     0000-0001-9008-2190, asayedzadeh@kums.ac.ir
  • Elaheh Malakan Rad, Department of Pediatrics, Division of Cardiology, The Children’s Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran

    Elaheh Malakan Rad, Department of Pediatrics, Division of Cardiology,

    The Children’s Hospital Medical Center, Pediatric Center of Excellence,

    Tehran University of Medical Sciences, Tehran, Iran 0000-0001-7824-6973

  • Behnaz Bazargani, Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Behnaz Bazargani, Pediatric Chronic Kidney Disease Center, The Children’s

    Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 0000-

    0001-8938-7376 bazarganibe@gmail.com

  • Arash Abasi, Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    . Arash Abasi. Pediatric Chronic Kidney Disease Center, The Children’s

    Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 0000-

    0002-0008-2937, arash.ped@gmail.com

  • Mastaneh Moghtaderi, Pediatric Chronic Kidney Disease Center, The Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    . Mastaneh Moghtaderi, Pediatric Chronic Kidney Disease Center, The

    Children’s Medical Center, Tehran University of Medical Sciences, Tehran,

    Iran. 0000-0001-6862-4504, drmoghtaderi@gmail.com

  • Afshin Safaeiasl, Pediatric Kidney Diseases Research Center, Guilan University of Medical Science, Rasht, Iran

    Afshin Safaeiasl, Pediatric Kidney Diseases Research Center, Guilan

    University of Medical Science, Rasht, Iran. 0000-0001-9820-5984,

     afshin_safaei2@yahoo.com

  • Nasrin Esfandiar, Department of Pediatrics, Pediatric Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    . Nasrin Esfandiar, Department of Pediatrics, Pediatric Nephrology Research

     Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-

    0001-6721-1206, nasrinesfandiar@gmail.com

  • Ali Derakhsan, Department of Pediatrics, Section of Nephrology, Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    . Ali Derakhsah, Department od Pediatrics, Section of Nephrology, Shiraz

     Nephro-Urology Research Center, Shiraz University of Medical Sciences,

    Shiraz, Iran. 0000-0002-7285-5046, derakksh@sums.ac.ir

  • Hamidreza Badeli, Pediatric Kidney Diseases Research Center, Guilan University of Medical Science, Rasht, Iran

    Hamidreza Badeli, Pediatric Kidney Diseases Research Center, Guilan

    University of  Medical Science, Rasht, Iran. 0000-0002-8861-3789,

    Badeli@gums.ac.ir

  • Alireza Eskandarifar, Department of Pediatrics, Section of Nephrology, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Alireza Eskandarifar, Department of Pediatrics, Section of Nephrology,

    Kurdistan University of Medical Sciences, Sanandaj, Iran. 0000-0001-9173-

    359x, are1372@gmail.com

  • Mojgan Mazaheri, Department of Pediatrics, Section of Nephrology, Semnan University of Medical Sciences, Semnan, Iran

    . Mojgan Mazaheri, Department of Pediatrics, Section of Nephrology,

    Semnan University of  Medical Sciences, Semnan, Iran. 0000-0003-2942-4280,

    mojganmazaheri@yahoo.com

  • Fatemeh Ghane Sharbaf, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    . Fatemeh Ghane Sharbaf, Kidney Transplantation Complications Research

    Center, Mashhad University of Medical Sciences, Mashhad, Iran.

     ghanef@mums.ac.ir

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Published

2022-11-30

Issue

Section

REVIEW | Transplantation