Evidence- and Consensus-based European Guideline for Immunosuppressive Therapy After Pediatric Kidney Transplantation
BACKGROUND: There is a lack of robust evidence regarding immunosuppressive therapy in children and adolescents after kidney transplantation (KTx), and as such, international practice is highly variable. Recent clinical practice recommendations advocating individualized immunosuppressive strategies that incorporate newer agents are often not implemented. This can potentially contribute to reduced patient and renal allograft survival. METHODS: The guideline was developed between January 1, 2024, and December 12, 2025, according to the Guidance Manual of the German Association of Scientific Medical Societies by the German Societies for Pediatric Nephrology, Nephrology, Transplantation, and Pediatrics, the German Kidney Association, the International Pediatric Transplant Association, the European Society for Pediatric Nephrology and the Members of the Cooperative European Pediatric Renal Transplant Initiative. RESULTS: This evidence- and consensus-based guideline provides up-to-date, state-of-the-art recommendations for immunosuppressive therapy after KTx in pediatric kidney transplant recipients. It is based on the best available evidence and the consensus of the relevant German Medical Societies, Members of the Cooperative European Paediatric Renal Transplant Initiative, and the working group on transplantation of the European Society for Paediatric Nephrology, and the International Pediatric Transplant Association. CONCLUSIONS: The formal consensus reached is particularly significant in cases of weak or inconclusive evidence and where recommendations are based solely on expert opinion.
Authors
- Alexander Fichtner (ORCID: https://orcid.org/0000-0002-9939-4059)
- Stefanie Jeruschke
- Svitlana Fomina (ORCID: https://orcid.org/0000-0001-7483-9712)
- Uwe Korst
- Łukasz Obrycki (ORCID: https://orcid.org/0000-0002-5134-8643)
- Andrea Pasini (ORCID: https://orcid.org/0000-0001-8479-8379)
- Tomáš Seeman (ORCID: https://orcid.org/0000-0003-1371-3096)
- Marco Busutti (ORCID: https://orcid.org/0000-0002-3150-6704)
- Christian Patry (ORCID: https://orcid.org/0000-0002-1270-6508)
- Evgenia Preka (ORCID: https://orcid.org/0000-0001-7130-0439)
- Jon Jim Kim
- Thurid Ahlenstiel-Grunow
- Britta Höcker (ORCID: https://orcid.org/0000-0003-4131-2273)
- Nils Pape
- Gregor Novljan (ORCID: https://orcid.org/0000-0001-9603-9855)
- Zainab Arslan (ORCID: https://orcid.org/0000-0002-1126-3995)
- Huib de Jong
- Nina Battelino
- Mieczysław Litwin (ORCID: https://orcid.org/0000-0002-5241-2483)
- Diletta Domenica Torres
- Raphael Schild
- Mario Schiffer (ORCID: https://orcid.org/0000-0002-8414-1470)
- Fabian Eibensteiner (ORCID: https://orcid.org/0000-0001-5012-3082)
- Ali Düzova (ORCID: https://orcid.org/0000-0002-4365-2995)
- Jelena Stojanović (ORCID: https://orcid.org/0000-0001-9887-9081)
- Sara Testa (ORCID: https://orcid.org/0000-0003-3062-8985)
- Carl Grabitz
- M. Pohl (ORCID: https://orcid.org/0000-0001-7861-1707)
- Mercedes López González (ORCID: https://orcid.org/0000-0003-0490-6857)
- Jun Oh
- Susanne Rieger
- Elisabeth Cornelissen
- M Nothacker
- Agnieszka Prytula
- Anna Grünewald
- Nele Kanzelmeyer
- Stephen Marks
- Raffaela Labbadia
- Jan Dudley
- Bora Gulhan
- Burkhard Tönshoff
- Lars Pape
- Julien Hogan
- Lutz T. Weber
- Andreea-Liana Bot Rachisan
- Anette Melk
- Antonia Bouts
Institutions
- Hebron University (PS)
- Radboud University Nijmegen (NL)
- Inserm (FR)
- Universität Hamburg (DE)
- Université Paris Cité (FR)
- Iuliu Hațieganu University of Medicine and Pharmacy (RO)
- Charles University (CZ)
- Heidelberg University (DE)
- Great Ormond Street Hospital (GB)
- Great Ormond Street Hospital for Children NHS Foundation Trust (GB)
- Association of the Scientific Medical Societies (DE)
- University Hospitals Bristol NHS Foundation Trust (GB)
- Ghent University Hospital (BE)
- University Medical Center Freiburg (DE)
- Ljubljana University Medical Centre (SI)
- University Hospital Heidelberg (DE)
- Nottingham City Hospital (GB)
- Radboud University Medical Center (NL)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Medizinische Hochschule Hannover (DE)
- Institute of Nephrology of the National Academy of Medical Sciences of Ukraine (UA)
- Universitätsklinikum Erlangen (DE)
- Emma Kinderziekenhuis (NL)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- University Hospital in Motol (CZ)
- University Medical Center Hamburg-Eppendorf (DE)
- Amalia Kinderziekenhuis (NL)
- Children's Memorial Health Institute (PL)
- Essen University Hospital (DE)
- Bambino Gesù Children's Hospital (IT)
- Hôpital Robert-Debré (FR)
- Vall d'Hebron Hospital Universitari (ES)
- Paris Cardiovascular Research Center (FR)
- Ospedale Pediatrico Giovanni XXIII (IT)
- University Hospital Cologne (DE)
- Bundesverband Flachglas (DE)
- University College London (GB)
- Hacettepe University (TR)
- Medical University of Vienna (AT)
- University of Amsterdam (NL)
- Erasmus University Rotterdam (NL)
Publication Details
- Journal
- Transplantation
- Published
- 2026-06-17
- DOI
- https://doi.org/10.1097/tp.0000000000005772
- Primary Topic
- Renal Transplantation Outcomes and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00