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Renal Transplantation for Children: Another View

John B. Reinhart, MD; John P. Kemph, MD
JAMA. 1988;260(22):3327-3328. doi:10.1001/jama.1988.03410220111037.
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MOST patients who undergo renal transplantation are more competent physically, cognitively, and emotionally than before they received the transplant.1,2 Simmons,3 using a variety of measures, demonstrated clearly that in most cases, the quality of life is far superior with transplantation than with dialysis. However, the quality of life of transplant recipients is not ideal. They must take drugs daily to prevent rejection and undergo frequent examinations and laboratory tests. They must deal with the side effects of the immunosuppressive drugs. They must live with the uncertainty that their graft might fail at any time. This type of problem, often encountered in the treatment of leukemia, has been aptly called "the Damocles syndrome"4 because patients feel as if they are lying beneath the sword of Damocles.

Children who receive transplants have additional concerns about, eg, growth retardation and delay in puberty. They also must cope with the tasks


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