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Paediatric transplantation comes of age

BMJ 1998; 317 doi: (Published 03 October 1998) Cite this as: BMJ 1998;317:897

The main problem now is shortage of donors 

  1. Deirdre Kelly, Reader in paediatric hepatology,
  2. AD Mayer, Consultant hepatobiliary and transplant surgeon
  1. Birmingham Children's Hospital, Birmingham B4 6NH

    The successful development of solid organ transplantation has revolutionised the outlook for many infants and children dying of liver, kidney, or cardiac failure. Over the past two decades rapid advances in both medical knowledge and surgical technique have not only extended the range of indications for transplantation but have also led to improved survival and good quality of life.

    End stage renal disease affects about 150 children a year in Britain. Many of these children are kept alive by renal dialysis but at considerable physical, psychological, and financial cost. Half the children requiring renal replacement are aged under 12, but until 10 years ago the results of transplantation in small children were discouraging because of graft loss due to technical complications. A combination of technical advances and clinical experience has now made transplantation the preferred option for children with renal failure.

    The high rate of vascular thrombosis has been reduced …

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