ArticlePediatric nephrology (Berlin, Germany)2026
Changes in maintenance immunosuppression after pediatric kidney transplantation-a report from the Nordic pediatric kidney transplantation registry.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Growth and development following paediatric kidney transplantation: Mechanisms, influencing factors, and clinical management.World journal of transplantation · 2026Review
- Temporary mycophenolate discontinuation and reintroduction in pediatric kidney transplantation: predictors and long-term outcomes.Pediatric nephrology (Berlin, Germany) · 2026Article
- Population Pharmacokinetics Model of Cyclosporin A in Children and Young Adult Renal Transplant Patients: Focus on Haemoglobin Contribution to Exposure Variability.Pharmaceutics · 2026Article
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12 authors.
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Abstract
backgroundFew studies are available on changes in maintenance immunosuppression after pediatric kidney transplantation (KT). This is a retrospective registry analysis of the long-term medication modifications in the Nordic countries.
methodsAll pediatric KT recipients transplanted between the years 2005 and 2016 were identified from the Scandiatransplant registry. Of the 482 patients, 345 met the inclusion criteria: age below 16 years at KT and at least 2 years post-transplant follow-up.
resultsA change in maintenance immunosuppression occurred in 160 patients (46.4%) at 2.0 (interquartile range 1.0-3.0) years median time from KT. The most common change (35.8%) was switching cyclosporine A (CsA) to tacrolimus (Tac). Initial CsA treatment was modified significantly more often compared to Tac (72.0% vs. 6.0%; p < 0.001). Modifications of mycophenolate mofetil (MMF) were observed more often in recipients aged < 2 (75.0%) and 2-5 (55.6%) years compared with 5-16 years (13.2%; p < 0.001); particularly, MMF discontinuation was common (< 2 years 45.8% and 2-5 years 38.9%). Otherwise, initial immunosuppression remained mainly unchanged. The main reasons for changing CsA to Tac were cosmetic side effects (26.2%), rejections (26.2%), and declining graft function (23.0%). In case of rejection or declining graft function, CsA-to-Tac conversion slowed the decrease in measured glomerular filtration rate. MMF modifications did not affect graft survival from 2 to 7.5 years post-transplant.
conclusionsMaintenance immunosuppression is modified in almost half of pediatric KT recipients. Particularly, CsA conversion to Tac and young recipients' MMF modifications are common.
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