Evidence- and Consensus-based European Guideline for Immunosuppressive Therapy After Pediatric Kidney Transplantation

Grünewald A, Ahlenstiel-Grunow T, Arslan Z, Battelino N, Rachisan ALB, Bouts A, Busutti M, Cornelissen E, de Jong H, Dudley J, Düzova A, Eibensteiner F, Fichtner A, Fomina S, Gonzalez ML, Gulhan B, Grabitz C, Hogan J, Höcker B, Jeruschke S, Kanzelmeyer N, Kim JJ, Korst U, Labbadia R, Litwin M, Marks S, Melk A, Novljan G, Obrycki L, Oh J, Pape N, Pasini A, Patry C, Pohl M, Preka E, Prytula A, Rieger S, Schiffer M, Schild R, Seeman T, Stojanovic J, Testa S, Tönshoff B, Torres DD, Weber LT, Nothacker M, Pape L (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Book Volume: 110

Pages Range: e1889-e1915

Journal Issue: 9

DOI: 10.1097/TP.0000000000005772

Abstract

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 with CRIS profile

Involved external institutions

Universitätsklinikum Essen Germany (DE) Children's Memorial Health Institute / Instytut "Pomnik - Centrum Zdrowia Dziecka" Poland (PL) University College London (UCL) United Kingdom (GB) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Ljubljana University Medical Centre (Ljubljana UMC) / Univerzitetni klinični center Ljubljana Slovenia (SI) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Ospedale Pediatrico Bambino Gesu Italy (IT) Universität Münster (ehem. Westfälische Wilhelms-Universität (WWU)) Germany (DE) University of Bologna / Università di Bologna Italy (IT) Universitätsklinikum Heidelberg Germany (DE) Universitätsklinikum Freiburg Germany (DE) Université Paris Cité France (FR) University Hospital Ghent Belgium (BE) Iuliu Hațieganu University of Medicine and Pharmacy / Universitatea de Medicină și Farmacie "Iuliu Hațieganu" (UMF Cluj) Romania (RO) Academic Medical Centre / Academisch Medisch Centrum (AMC) Netherlands (NL) Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC) Netherlands (NL) Erasmus University Rotterdam (EUR) / Erasmus Universiteit Rotterdam Netherlands (NL) University Hospitals Bristol NHS Foundation Trust United Kingdom (GB) Medizinische Universität Wien Austria (AT) National Academy of Medical Sciences of Ukraine (NAMS) / NAMS Ukraine Ukraine (UA) Vall d'Hebron University Hospital / Hospital Universitari Vall d'Hebron Spain (ES) Hacettepe University Turkey (TR) Hôpital Universitaire Robert-Debré France (FR) Nottingham University Hospitals United Kingdom (GB) Bundesverband Niere e.V. Germany (DE) Motol University Hospital / Fakultní nemocnice v Motole Czech Republic (CZ) Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico Italy (IT) Giovanni XXIII Pediatric Hospital / Ospedale Pediatrico Giovanni XXIII Italy (IT) Universitätsklinikum Köln Germany (DE) Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. (AWMF) e.V. Germany (DE)

How to cite

APA:

Grünewald, A., Ahlenstiel-Grunow, T., Arslan, Z., Battelino, N., Rachisan, A.L.B., Bouts, A.,... Pape, L. (2026). Evidence- and Consensus-based European Guideline for Immunosuppressive Therapy After Pediatric Kidney Transplantation. Transplantation, 110(9), e1889-e1915. https://doi.org/10.1097/TP.0000000000005772

MLA:

Grünewald, Anna, et al. "Evidence- and Consensus-based European Guideline for Immunosuppressive Therapy After Pediatric Kidney Transplantation." Transplantation 110.9 (2026): e1889-e1915.

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