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ARTICLE |

Renal Transplantation for Children FREE

S. Michael Mauer, MD; Arthur Caplan, MD; Thomas E. Nevins, MD; John S. Najarian, MD
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Edited by Drummond Rennie, MD, Deputy Editor (West).


JAMA. 1989;262(3):348-348. doi:10.1001/jama.1989.03430030036011
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To the Editor. —  In their commentary, Drs Reinhart and Kemph1 express concern about the proportional benefit of renel transplantation in children. We agree that older children (6 to 7 years and older) should be included in the information and consent process and that their emerging autonomy must be respected. Unpleasant options including no active treatment, as well as the risks, costs, and inconveniences of all possible therapies, should be explored thoroughly. The lure of paternalism or unfair efforts to influence or limit the family's choices must be avoided. At the same time, the pediatrician must be the primary professional advocate for the patient and only secondarily for the family and society.Unfortunately, the commentary by Drs Reinhart and Kemph is seriously inaccurate. While they pose an important question, it is placed in a 20-year-old time frame. Their references to the pediatric transplantation literature are out of date, most

REFERENCES

Reinhart JB, Kemph JP.  Renal transplantation for children: another view . JAMA . 1988;;260:3327-3328.
So SKS, Mauer SM, Nevins TE, et al.  Current results in pediatric renal transplantation at the University of Minnesota . Kidney Int Suppl. 1986;;30:25-30.
Potter D, Feduska N, Meizer J, et al.  Twenty years of renal transplantation in children . Pediatrics . 1986;;77:465.
So SKS, Najarian JS, Nevins TE, et al.  Low dose cyclosporine combined with standard immunosuppression in pediatric renal transplantation . J Pediatr. 1987;;110:1017-1021.
So SKS, Chang P-N, Najarian JS, Mauer SM, Simmons RL, Nevins TE.  Growth and development in infants after renal transplantation . J Pediatr. 1987;;110:343-350.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Reinhart JB, Kemph JP.  Renal transplantation for children: another view . JAMA . 1988;;260:3327-3328.
So SKS, Mauer SM, Nevins TE, et al.  Current results in pediatric renal transplantation at the University of Minnesota . Kidney Int Suppl. 1986;;30:25-30.
Potter D, Feduska N, Meizer J, et al.  Twenty years of renal transplantation in children . Pediatrics . 1986;;77:465.
So SKS, Najarian JS, Nevins TE, et al.  Low dose cyclosporine combined with standard immunosuppression in pediatric renal transplantation . J Pediatr. 1987;;110:1017-1021.
So SKS, Chang P-N, Najarian JS, Mauer SM, Simmons RL, Nevins TE.  Growth and development in infants after renal transplantation . J Pediatr. 1987;;110:343-350.
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