The most common causes of end-stage renal disease (ESRD) in children are congenital, cystic, and hereditary diseases, which combined account for 38% of incident cases. The most common disorders in this category are congenital obstructive uropathies (9.5%) and renal hypoplasia/dysplasia (10%). Primary glomerular disease is the second-most common etiology accounting for 25% of new cases, predominantly due to focal segmental glomerulosclerosis (FSGS). Secondary glomerulonephritis and vasculitis account for 12% of new cases, of which lupus nephritis is the most common. The underlying etiology of ESRD also varies by age of presentation. As expected, congenital/hereditary/cystic disorders are the most common underlying cause of ESRD amongst the youngest age groups, while primary and secondary glomerular diseases are the leading cause among adolescents.

Kidney transplantation is the preferred treatment for ESRD in children and confers improved survival, skeletal growth, heath-related quality of life, and neuropsychological development compared to dialysis.

Transplantation is initially considered when renal replacement therapy is imminent. Due to increased risk of graft loss and mortality in very young children, most pediatric centers perform kidney transplantation once children achieve a weight above 10–15 kg, which is typically around the age of 2 years. The underlying etiology for kidney failure, the rapidity of decline in kidney function, and the age and size of the patient determine whether an individual can receive a pre-emptive kidney transplant without preceding dialysis, which may provide a graft survival advantage. On average, 30% of pediatric kidney transplant recipients in the U.S. receive pre-emptive transplant, and an additional 24% receive dialysis treatment for less than 1 year prior to transplant.

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The use of Implantable Corneas from Pig Skin to Restore Vision

Scientists in Sweden from Linköping University have successfully developed implantable corneas from pig skin for 14 previously blind patients. From sites in Iran and India, a study was performed on 20 patients who got an implant for restoring their corneal thickness and curvature to a normal level. The visual outcome was perfect as a human-donated cornea was used.

An implant rejection was prevented due to an eight-week course of immunosuppressive eye drops used instead of the normal regimen typically used following a human corneal transplant. An eight-week course of immunosuppressive eye drops was enough to prevent implant rejection, much shorter than the regimens typically used following a human corneal transplant.

According to the analytics firm Vision Research Reports, the corneal implants market is around $420 million this year but it is expected to increase to $700 million by 2030. This growth is due to the rising prevalence of corneal diseases and the interest of industries in bioengineered, 3D-printed, and stem cell-derived corneas.

Source: Pharmiweb

 corneal / pig / Sweden / Linköping University  / Iran / Transplant

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The renal transplant program in Iran is one of the successful programs in the region. In 1988, a controlled live unrelated renal transplant program was started in Iran because of a low numbers of live related donors and because cadaveric renal transplant program was not established completely at that time.

Finally, therenal transplant waiting list of the country was eliminated by the end of 1999.

Recently, in the annual report of NAPRTCS, 48.6% of all transplants were from deceased donor, 41.2% were from a parent, with the remaining 10.2% from other living donors.

In developing countries, the donor sources vary depending on cultural and ethical status.

In some countries, most transplants are from living related donors, such as Egypt and some Asian countries.

In contrast, in some other countries, the majority of transplants are from deceased donors such as South Africa, Thailand…

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