Preparing the Child with End-Stage Renal Disease for a Renal Transplant: the Pre-transplant Assessment

We review the pre-transplant assessment of the renal transplant candidate, highlighting specific issues that are unique to the pediatric patient. The pre-transplant assessment consists of a thorough history and physical examination, supplemented by laboratory evaluations based on a systems-based approach. Considerations that are unique to the pediatric population include the assessment of immunization, nutritional and developmental status, as well as for underlying urological abnormalities that require management prior to transplantation. A thorough and complete pre-transplant assessment identifies comorbidities that require management prior to transplantation, anticipates potential risks and complications peri- and post-transplant, and facilitates planning for risk mitigating strategies and post-transplant management to maximize allograft and patient survival.