Solid Organ Transplantation

The number of children and adolescents surviving and thriving with solid organ transplants is increasing. This chapter will help to outline the important health consequences and medication effects that can occur in these patients that their providers need to be aware of. The transplant patient will be living with two chronic conditions—the original one that necessitated the transplant and the side effects of having had the transplant. The disease that can lead to transplant is associated with metabolic bone disease and delayed physical and social-emotional development. After transplant, the immunosuppressant medications, usually including calcineurin inhibitors (CI), are associated with a host of side effects. They can cause hypertension, diabetes mellitus, hyperlipidemia, and earlier onset of cardiovascular disease. These medications can worsen metabolic bone disease, hyperuricemia, and gout. Finally, the patients are at enhanced risk for infections and cancers (especially skin and genitourinary) that are more common in immunosuppressed patients and require additional screening.