Renal transplantation (tx) restores kidney function temporarily and improves the prospects of a normal life as compared to dialysis. During the last forty years great progress has been made in renal transplantation and its follow up treatment. However, preserving long-term graft function is still a major challenge. Therefore, it is crucial to review our practices in pediatric transplantation and to evaluate patient outcome as the first step in enhancing future prospects. Following renal tx a chronic multifactorial physical and mental condition persists both for the child and its caregivers. Life-long dependence on immunosuppressive treatment (IS) and concomitant comorbidities after tx (e.g. progressive decline in renal function, hypertension, hyperlipidemia and excessive weight gain) render these children at increased risk for future cardiovascular (CV) morbidity and mortality. Based on structural and functional echocardiographic findings post-tx, these children have been forecast a rather gloomy CV prognosis including cardiomyopathy and heart failure in adult life. However, little attention has so far been paid to the levels of physical activity and cardiorespiratory fitness (CR fitness, V02peak) as global markers of CV health and physical functioning in tx children and adult survivors. Furthermore, more knowledge is required of the impact of tx on health related quality of life (HRQOL) for the child and its caregivers following, predominantly, parental kidney donation.
List of papers. Papers I-III are removed from the thesis due to copyright restrictions.
Paper I: Tangeraas T, Bjerre A, Lien B, Kyte A, Monn E, Cvancarova M, Leivestad T, Reisæter AV. Long-term outcome of pediatric renal transplantation: The Norwegian experience in three eras 1970-2006.
Pediatr Transplant 2008 12:762-768. doi:10.1111/j.1399-3046.2007.00896.x
Paper II: Tangeraas T, Midtvedt K, Fredriksen PM, Cvancarova M, Bjerre A.
Cardiorespiratory fitness is a marker of cardiovascular health in renal transplanted children. Pediatr Nephrol 2010 Nov;25(11):2343-50. doi:10.1007/s00467-010-1596-9
Paper III: Tangeraas T, Midtvedt K, Hirth A, Cvancarova M,Tonstad S, Fredriksen PM, Isaksen G,Bjerre A. Cardiorespiratory fitness in young adults with a history of renal transplantation in childhood. Pediatr Nephrol 2011 Nov;26(11):2041-2049. doi:10.1007/s00467-011-1898-6
Paper IV: Diseth T, Tangeraas T, Reinfjell T, Bjerre A. Kidney transplantation in childhood: Mental health and quality of life of children and caregivers. Pediatr Nephrol 2011 Oct;26(10):1881-1892. doi:10.1007/s00467-011-1887-9Published under a Creative Commons Attribution License.