학술논문
Revisiting the Management of Pediatric Kidney Transplants, A Multicenter Analysis
Document Type
Academic Journal
Author
Assadi F; Hooman N; Seyedzadeh A; Azarfar A; Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. azarfara@mums.ac.ir.; Malakan Rad E; Bazargani B; Abasi A; Moghtaderi M; Safaeiasl A; Esfandiar N; Derakhsan A; Badeli H; Eskandarifar A; Mazaheri M; Ghane Sharbaf F
Source
Publisher: Iranian Society of Nephrology Country of Publication: Iran NLM ID: 101316967 Publication Model: Print Cited Medium: Internet ISSN: 1735-8604 (Electronic) Linking ISSN: 17358582 NLM ISO Abbreviation: Iran J Kidney Dis Subsets: MEDLINE
Subject
Language
English
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.