A recent paper published in Pediatric Transplantation from UK elegantly discusses 7 steps for every physician taking care of a child post transplantation,whether it is liver/ bone marrow/ stem cell.
- Renal function should be monitored regularly in organ transplant recipients, utilizing assessment of serum creatinine
- Also by cystatin C
- GFR should be calculated using the new Schwartz formula.
- Transplant physicians should also monitor blood pressure using automated oscillometric devices and
- Confirm repeated abnormal measures with manual blood pressure readings and ambulatory 24-h blood pressure monitoring.
- Proteinuria and microalbuminuria should also be assessed regularly.
- Referrals to a pediatric nephrologist should be made for non-renal organ transplant recipients with repeated blood pressures >95th percentile using the Fourth Task Force reference intervals, microalbumin/creatinine ratio >32.5 mg/g (3.7 mg/mmol) creatinine on repeated testing and/or GFR <90 mL/min/1.73 m(2) .