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World J Transplant. Dec 18, 2024; 14(4): 95967
Published online Dec 18, 2024. doi: 10.5500/wjt.v14.i4.95967
Optimizing growth in pediatric renal transplant recipients: An update
Manoji Gamage, Randula Ranawaka
Manoji Gamage, Nutrition Division, Ministry of Health, Colombo 0094, Sri Lanka
Manoji Gamage, Medical Nutrition Unit, National Institute of Nephrology, Dialysis and Transplant, Colombo 0094, Sri Lanka
Randula Ranawaka, Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo 0094, Sri Lanka
Randula Ranawaka, University Paediatric Unit, Lady Ridgeway Hospital for Children, Colombo 0094, Sri Lanka
Author contributions: Ranawaka R and Gamage M performed the literature survey; Ranawaka R and Gamage M wrote the manuscript; Gamage M and Ranawaka R edited the final version of the manuscript. Both authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Randula Ranawaka, MBBS, MD, Chief Physician, Professor, Senior Researcher, Department of Paediatrics, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 0094, Sri Lanka. randula@pdt.cmb.ac.lk
Received: April 23, 2024
Revised: June 20, 2024
Accepted: July 15, 2024
Published online: December 18, 2024
Processing time: 149 Days and 22.1 Hours
Core Tip

Core Tip: Growth retardation is a notable challenge among pediatric kidney transplant recipients. Key risk factors for delayed final adult height include early age at transplantation, pre-existing short stature due to chronic kidney disease and dialysis, and the use of certain immunosuppressive drugs, particularly steroids. To effectively manage growth retardation, early intervention is crucial, ideally beginning before transplantation. Important strategies include administering recombinant growth hormone both before and after the transplant, optimizing nutrition, and employing protocols designed to minimize steroid use. These approaches offer the best chances for achieving catch-up growth in renal transplant recipients.