Overview of pediatric organ transplantation

PURPOSE OF REVIEW: The main aim of this review is to highlight the current advances and significant challenges associated with pediatric organ transplantation, and to explore future perspectives. RECENT FINDINGS: Pediatric organ transplantation has greatly improved survival and management of pathological conditions resistant to therapeutic interventions in pediatric populations with end-stage organ failure, and is regarded as a treatment of choice. Advent of immunosuppressive therapies has significantly enhanced the care of these patients and graft survival rates, but the long-term risks of these therapeutic interventions are not well recognized and promote numerous challenges particularly in the pediatric population, due to their off-label use and significant adverse effects that may impact growth, skeletal development, and quality of life. Data regarding the safety of these drugs in children are scare due to the lack of randomized clinical trials in this age group, mainly because of issues related to conducting clinical trials in children and to the small number of pediatric transplantation cases per year. SUMMARY: It is important to generate registries of pediatric patients with organ transplantation for conducting observational studies, which might provide information for designing future RCTs and new insights toward improving the survival rates and long-term predictors of response.