Introduction
Population | Intervention | Comparison | Outcome | Study design |
---|---|---|---|---|
Children (< 18 years) undergoing renal transplantation | Basiliximab, Tacrolimus, Prednisolone, Mycophenolate Mofetil, Azathioprine Valganciclovir Valaciclovir Co-trimoxazole | Any intervention compared with any other or no intervention | Mortality, Hospitalisations, Graft failure, Acute rejection, Infections, Growth. | Randomised controlled trials (RCT), non-randomised studies if adjusted for key confounders (age, health at baseline, co-morbidities). |
Summary of recommendations for immunosuppressive (ISD) and anti-infective drug prescribing and monitoring in children and young people receiving routine, initial therapy for kidney-only transplantation
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≥ 35 kg: 20 mg.
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< 35 kg: 10 mg.
Day of transplant (d0): | (methylprednisolone - see Q5) |
---|---|
Day 1 post transplant (d1): | 60 (maximum dose 60 mg) |
Day 2 post transplant (d2): | 40 (maximum dose 40 mg) |
Day 3 post transplant (d3): | 30 (maximum dose 30 mg) |
Day 4 post transplant (d4): | 20 (maximum dose 20 mg) |
Day 5 onwards: (d5): | 0 |
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≥ 35 kg: 20 mg.
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< 35 kg: 10 mg.
Day of transplant (d0): | methylprednisolone (see Recommendation 5) |
---|---|
Day 1–2 post transplant: | 60 (maximum dose 60 mg) |
Day 3–7 post transplant: | 40 (maximum dose 40 mg) |
Day 8–14 post transplant: | 30 (maximum dose 30 mg) |
Day 15–21 post transplant: | 20 (maximum dose 20 mg) |
Day 22–28 post transplant: | 10 (maximum dose 10 mg) |
Day 29–90 post transplant: | 10 (maximum dose 10 mg) on alternate days |
Day 91 post transplant-> | 5 (maximum dose 5 mg) on alternate days |
Summary of audit measures for immunosuppressive and anti-infective drug prescribing and monitoring in children and young people receiving routine, initial therapy for kidney-only transplantation
Summary of research recommendations for immunosuppressive and anti-infective drug prescribing and monitoring in children and young people receiving routine, initial therapy for kidney-only transplantation
Rationale for clinical practice recommendations for immunosuppressive and anti-infective drug prescribing and monitoring in children and young people receiving routine, initial therapy for kidney-only transplantation
Audit measure
Rationale
Rationale
-
≥ 35 kg: 20 mg.
-
< 35 kg: 10 mg.
Day of transplant (d0): | (methylprednisolone - see Q5) |
---|---|
Day 1 post transplant (d1): | 60 (maximum dose 60 mg) |
Day 2 post transplant (d2): | 40 (maximum dose 40 mg) |
Day 3 post transplant (d3): | 30 (maximum dose 30 mg) |
Day 4 post transplant (d4): | 20 (maximum dose 20 mg) |
Day 5 onwards: (d5): | 0 |
Audit measure
Rationale
-
≥ 35 kg: 20 mg.
-
< 35 kg: 10 mg.
Day of transplant (d0): | methylprednisolone (see Recommendation 5) |
---|---|
Day 1–2 post transplant: | 60 (maximum dose 60 mg) |
Day 3–7 post transplant: | 40 (maximum dose 40 mg) |
Day 8–14 post transplant: | 30 (maximum dose 30 mg) |
Day 15–21 post transplant: | 20 (maximum dose 20 mg) |
Day 22–28 post transplant: | 10 (maximum dose 10 mg) |
Day 29–90 post transplant: | 10 (maximum dose 10 mg) on alternate days |
Day 91 post transplant-> | 5 (maximum dose 5 mg) on alternate days |
Audit measure
Rationale
Audit measure
Rationale
Audit measure
Rationale
Audit measure
Rationale
Audit measures
Rationale
Audit measures
Rationale
Audit measures
Rationale
Rationale for research recommendations for immunosuppressive and anti-infective drug prescribing and monitoring in children and young people receiving routine, initial therapy for kidney-only transplantation
Rationale
Information for parents and carers of children and young people receiving routine, kidney-only transplantation
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Health professionals with specialist knowledge in kidney transplantation offer you information on the available treatments and their side effects.
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Prescribing of immunosuppression or ‘anti-rejection’ treatment is standardised across the UK in 2 agreed ‘regimens’ to reduce variation in practice.
Acknowledgements
Delphi panelists
Dr Caroline Booth, Consultant Paediatric Nephrologist, Evelina, London | |
Dr Rodney Gilbert, Consultant Paediatric Nephrologist, Southampton | |
Dr Carol Inward, Consultant Paediatric Nephrologist, Bristol | |
Dr Caroline Jones, Consultant Paediatric Nephrologist, Liverpool | |
Dr Jon Jin Kim, Consultant Paediatric Nephrologist, Nottingham | |
Dr Raj Krishnan, Consultant Paediatric Nephrologist, Cardiff | |
Dr Heather Lambert, Consultant Paediatric Nephrologist, Newcastle | |
Dr Matko Marlais, Consultant Paediatric Nephrologist, Great Ormond St, London | |
Dr Karl McKeever, Consultant Paediatric Nephrologist, Belfast | |
Dr Mordi Muorah, Consultant Paediatric Nephrologist, Birmingham | |
Dr Nick Plant, Consultant Paediatric Nephrologist, Manchester | |
Dr Ian Ramage, Consultant Paediatric Nephrologist, Glasgow | |
Dr Kay Tyerman, Consultant Paediatric Nephrologist, Leeds | |
Dr Cath Byrne, Consultant Nephrologist, Nottingham | |
Dr Sunil Daga, Consultant Nephrologist, Leeds | |
Professor Hugh Gallagher, Consultant Nephrologist, St Hellier | |
Dr Raj Thuraisingham, Consultant Nephrologist, Barts, London | |
Mr Vlad Shumeyko, Consultant Transplant Surgeon, Glasgow | |
Mr Afshin Tavakioli, Consultant Transplant Surgeon, Manchester | |
Mr Sam Turner, Consultant Transplant Surgeon, Bristol | |
Ms Allison Birch, Transplant Nurse, Liverpool | |
Ms Sarah Grylls, Transplant Nurse, Southampton | |
Ms Denise Roberts, Transplant Nurse, Manchester | |
Mr Will Batten, Paediatric Renal Pharmacist, Bristol | |
Mr Andy Fox, Paediatric Renal Pharmacist, Southampton | |
Mr Peter Foxon, Paediatric Renal Pharmacist, Nottingham | |
Ms Tara Bashford, lay panellist, London | |
Ms Jennifer Hollins, lay panellist, Stoke | |
Mrs Michelle Rossiter, lay panellist, Southampton | |
Dr Alicia Demirjian, Consultant Microbiologist, Evelina London | |
Dr James Hatcher, Consultant Microbiologist, Great Ormond St, London | |
Dr Peter Muir, Consultant virologist, Bristol |