TY - JOUR
T1 - Kidney transplantation in pediatric patients with rheumatologic disorders
AU - Cody, Ellen
AU - Hooper, David K.
N1 - Funding Information:
E.C. receives funding from the Lupus Foundation of America. David Hooper is a consultant for Alnylam Pharmaceuticals Inc., Magnolia Innovation LLC., Bioporto Diagnostics Inc., and Kaneka Medical America LLC.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Purpose of reviewProviders 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 findingsRecent 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.SummaryIt 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.
AB - Purpose of reviewProviders 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 findingsRecent 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.SummaryIt 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.
KW - IgA
KW - IgAV
KW - anti-neutrophil cytoplasmic antibody ANCA
KW - pediatric
KW - rheumatologic
KW - systemic lupus erythematosus
KW - transplant
UR - http://www.scopus.com/inward/record.url?scp=85125553813&partnerID=8YFLogxK
U2 - 10.1097/MOP.0000000000001100
DO - 10.1097/MOP.0000000000001100
M3 - Review article
C2 - 34954727
AN - SCOPUS:85125553813
SN - 1040-8703
VL - 34
SP - 234
EP - 240
JO - Current opinion in pediatrics
JF - Current opinion in pediatrics
IS - 2
ER -