Pediatric kidney recipients may benefit from monitoring for donor-specific antibodies.

There are limited data regarding the presence of DSAs and their effect on graft function in pediatric renal transplantation. The role for serial DSA monitoring in routine clinical practice is unclear. All patients attending a regional transplant clinic were tested for DSAs, measured using Luminex single/mixed antigen beads.

Successful ABO incompatible renal transplantation following rituximab and DFPP after failed immunoadsorption.

Effective antibody removal using PE, DFPP and IA has led to increased access to live donor organs through ABOi RT for patients with chronic kidney disease. However, there have been no head-to-head comparator studies between these modalities, and the choice of technique is usually influenced by cost and institutional preference. We describe the clinical course of a child undergoing ABOi RT, in whom IA without preconditioning with rituximab did not achieve a satisfactory reduction in the antibody titers, who went on to have a successful living donor RT following rituximab and DFPP.

Assessing children's and parents' opinions on salivary sampling for therapeutic drug monitoring.

Aim: This paper describes preliminary development and pilot testing of a questionnaire to assess opinions on saliva sampling for therapeutic drug monitoring (TDM) in paediatric patients.

Background: Less distressing alternatives are needed for sampling body fluids from children and young people for TDM to obtain results that are as accurate as those attained from blood samples.

Data Sources: Two versions of a salivary sampling questionnaire were developed, one for young children and one for older children and young people and administered to two cohorts of 15 children and young people aged from eight to 19 years, and their parents.

Antithymocyte treatment of steroid-resistant acute rejection in renal transplantation.

To evaluate the outcome of early (ER <3 months) and late (LR >3 months) episodes of corticosteroid resistant acute allograft rejection (CRR) treated with anti-thymocyte globulin (ATG) in pediatric renal allograft recipients. Retrospective study of 15 children, mean age 13.2 y, who received ATG for the treatment of biopsy proven CRR over a 15 year period.

Extraperitoneal renal transplantation in small children results in a transient improvement in early graft function.

Renal transplantation is considered more technically challenging in small children compared to adults, especially when live donor adult kidneys are used. Transplanted kidneys have traditionally been placed intraperitoneally, although over the last decade extraperitoneal positioning has been attempted. The aim of this study was to establish whether there is a difference in kidney function and outcome dependent on the surgical approach to transplantation.

Fingerprick blood samples can be used to accurately measure tacrolimus levels by tandem mass spectrometry.

Regular monitoring of tacrolimus levels is an essential component of post-transplantation follow up in children receiving this drug. We have developed a high performance liquid chromatography tandem mass spectrometry (HPLC T-MS) methodology which measures whole blood tacrolimus levels using a 10 microL sample, thus allowing the use of fingerprick blood sampling. The aim of this study was to determine the degree of relationship between fingerprick and venous tacrolimus levels measured by HPLC T-MS and venous levels measured using the Abbott IMx tacrolimus II assay (IMx).