Transplantation—an overview in children

Abstract Advances in immunosuppression, organ preservation, refinements of the surgical technique, and effective antimicrobial prophylaxis have made paediatric transplantation a routine operation with excellent patient outcomes. However, a number of challenges are still faced by the transplant community such as shortage of size-matched organs. Over the years, several strategies have been developed to expand the donor pool, including use of donors with cardiac death and living donors. Although these techniques have led to a reduction in the waiting list mortality, further initiatives such as ABO-incompatible transplantation, gene therapy, and stem cell transplant are necessary to help bridge the increasing gap between organ supply and demand. Children have a longer potential lifespan following successful transplantation; hence, paediatric transplant recipients are facing the challenge of maintaining graft function whilst minimizing long-term immune and non-immune complications of immunosuppressive medications. With the recent advances and improved survival, issues regarding the quality of life in long-term survivors have come to the forefront.