Evaluation and post-transplant management of children after multi-organ-with-kidney transplantation

Pediatr Nephrol. 2024 Oct;39(10):2875-2885. doi: 10.1007/s00467-024-06336-2. Epub 2024 Mar 14.

Abstract

Multi-organ transplantation involves the transplant of two or more organs from a single donor into a single recipient; in most cases, one of these organs is a kidney. Multi-organ transplantation is uncommon in pediatric transplantation but can be life-saving or significantly life-improving for children with rare diseases, including primary heart, liver, pancreas, or intestinal failure with secondary kidney failure, metabolic disorders, and genetic conditions causing multi-organ dysfunction. This manuscript reviews the current state of pediatric multi-organ transplantation that includes a kidney, with a focus on indications, evaluation, and key differences in management compared to kidney-alone transplantation. Guidelines and consensus statements for pediatric multi-organ transplantation are nonexistent; this review condenses reported statistics and peer-reviewed expert opinion while highlighting areas in need of further research.

Keywords: Allocation; Heart-kidney transplantation; Kidney-pancreas transplantation; Liver-kidney transplantation; Multi-organ transplantation; Pediatric.

Publication types

  • Review

MeSH terms

  • Child
  • Graft Rejection / etiology
  • Graft Rejection / immunology
  • Graft Rejection / prevention & control
  • Humans
  • Kidney Transplantation* / adverse effects
  • Multiple Organ Failure / etiology
  • Organ Transplantation / adverse effects