Thursday, March 3, 2016

Seven steps for physicians taking care of children undergoing any transplant

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.

  1. Renal function should be monitored regularly in organ transplant recipients, utilizing assessment of serum creatinine
  2. Also by cystatin C
  3. GFR should be calculated using the new Schwartz formula. 
  4. Transplant physicians should also monitor blood pressure using automated oscillometric devices and 
  5. Confirm repeated abnormal measures with manual blood pressure readings and ambulatory 24-h blood pressure monitoring. 
  6. Proteinuria and microalbuminuria should also be assessed regularly. 
  7. 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) .

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