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Induction and Standard Immunosuppression

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Solid Organ Transplantation in Infants and Children

Part of the book series: Organ and Tissue Transplantation ((OTT))

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Abstract

Solid organ transplantation (SOT) is a life-saving procedure for patients with end-stage organ disease. In order to maximize long-term patient and allograft survival, transplant practitioners must skillfully maintain an overall net state of immunosuppression necessary to prevent allograft rejection while also limiting the risk of opportunistic infections, avoiding malignancy, and minimizing adverse effects of chronic immunosuppression. Biologic induction agents are utilized in the majority of pediatric SOT with the exception of liver transplant recipients. Modern-day maintenance immunosuppression in pediatric SOT typically consists of tacrolimus ± mycophenolate mofetil and/or corticosteroids. Due to ontogenic changes in growth and development, the absorption, distribution, metabolism, and excretion (ADME) properties of various drugs, especially immunosuppressive medications, may be difficult to predict and therefore require very close monitoring for safety and efficacy. Chronic administration of immunosuppressive medications in infants and children can negatively impact growth, development, and quality of life (QOL) that in some cases result in nonadherence to prescribed therapy, vastly compromising allograft survival.

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Authors and Affiliations

  1. Seattle Children’s Hospital, Seattle, WA, USA

    David M. Newland & Thomas L. Nemeth

Authors
  1. David M. Newland
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  2. Thomas L. Nemeth
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Correspondence to Thomas L. Nemeth .

Editor information

Editors and Affiliations

  1. Department of Surgery, Jefferson Medical College, Wilmington, Delaware, USA

    Stephen P. Dunn

  2. Division of Gastroenterology, Seattle Children’s Hospital, Seattle, Washington, USA

    Simon Horslen

Section Editor information

  1. Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Tetsu Uejima

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Newland, D.M., Nemeth, T.L. (2018). Induction and Standard Immunosuppression. In: Dunn, S., Horslen, S. (eds) Solid Organ Transplantation in Infants and Children. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07284-5_45

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  • DOI: https://doi.org/10.1007/978-3-319-07284-5_45

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07283-8

  • Online ISBN: 978-3-319-07284-5

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