Organ transplants in children

The success rate of organ transplants in children today is so great that more than 80% of them will experience youth and puberty. Organ transplants in children are performed in special cases that are different from adults. Like adults, children have heart, lung, kidney, small intestine or bone marrow transplants. Organ failure is also seen in children, sometimes due to inherited or congenital diseases. Due to the special circumstances in children, which are different from adults, having a skilled medical team familiar with these issues will be a great help to success. Some of these issues include the side effects of anti-transplant drugs, the patient’s quality of life, the prevention of infections and transplant rejection, and the patient’s transition from childhood to adolescence and adulthood.
Because children who are transplanted have to take anti-transplant drugs for the rest of their lives, the side effects of these drugs can sometimes cause them a lot of problems. For example, some anti-transplant drugs, such as cyclompurine, have kidney problems, so long-term use in children can lead to kidney failure and even the need for a kidney transplant. Corticosteroids are also associated with symptoms such as obesity, which in children or adolescents can lead to a feeling of bad appearance and unwillingness to take medication. Some medications also cause the patient to develop body hair and gingivitis, which is difficult for the child to accept. Therefore, the patient tends not to take drugs. There is a high tendency for children, especially adolescents, not to take the drug, and this condition sometimes leads to the loss of a transplanted organ. Of course, social and economic issues are also involved. Another important issue in child transplantation is infection. Because in many cases, an organ transplant is passed from adults to children (through parents or a corpse), transmission of viruses is common. Many adults have been exposed to these viruses before, but children have not usually been exposed to them. After transplantation, due to the use of anti-transplant drugs, the immune system is weakened and therefore sometimes these viruses are activated in the patient’s body and cause problems. Some of these viruses are even linked to cancers such as lymphatic system cancer. Therefore, it is necessary for the transplant team to carefully evaluate the patient in this regard and if it occurs, treat it immediately.
After transplantation, the patient’s nutritional and growth status usually improves and patients’ quality of life improves. However, some medications, especially corticosteroids, may interfere with the patient’s growth. For this reason, it is necessary to reduce or discontinue corticosteroids in these patients. Numerous studies have shown that, like adults, corticosteroids can be discontinued in children or not used at all.
Numerous studies in children have shown that these patients are in a much better condition after transplantation in terms of mental and educational status, compared to patients who have not yet been transplanted.
Another important issue in these patients is adolescence. Puberty in these patients usually has its normal course. But sometimes there is a tendency not to take medicine in these patients, which is due to the patient’s growth and independence. Therefore, it is necessary for the transplant team to make the necessary consultations with the patient and his family in this case.
Another important issue in this period is the appearance of the person, which can be affected by the side effects of medications such as obesity, hair growth or gingivitis. These physical and physical problems may have a bad effect on the patient and lead him to not take medication. Sometimes the survival of the transplanted organ may even be endangered due to not taking the drug.
In short, organ transplants in children are so successful that up to 80% of these patients will experience puberty and adulthood. However, it should be noted that these patients have certain issues that are different from adults. Therefore, it is necessary for an experienced team to take care of these patients to facilitate the patient’s recovery from childhood to adolescence and puberty.

Dr. Reza Saidi Firoozabadi – Transplant surgeon