Abstract
The risk of disease recurrence (DR) after renal transplantation (Tx) is relatively high in children and may lead to graft loss (GL), representing 7–8 % of all graft failures. Recurrence of the full disease may be associated with either a high risk of GL (focal and segmental glomerulosclerosis, membranoproliferative glomerulonephritis, oxalosis, atypical hemolytic uremic syndrome) or with a low risk of GL (IgA nephropathy, lupus, ANCA-associated glomerulonephritis). Recurrence may also occur with a delayed risk of GL, such as insulin-dependent diabetes mellitus and sickle cell disease. Adequate strategies should therefore be added to kidney Tx, such as pre-Tx genotyping, adequate donor selection, specific immunosuppression and/or biotherapy, associated liver Tx, etc. Under such conditions, very few patients would be excluded from kidney Tx only because of a major risk of DR. In the future, the issue of DR after kidney Tx may benefit from alternatives to organ Tx.
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