Perspectives in pediatric renal transplantation

New immunosuppressive drugs are administered in adults after renal transplantation to prevent toxicities (nephrotoxicity, cardiovascular complications...). Among these, Belatacept exhibited exciting results and its indication in pediatric patients will have to be validated, especially in EBV-positive recipients. Rituximab, bortezomide and eculizumab are also currently being evaluated in protocols of desensitization and in the treatment of humoral rejections. An individually tailored immunosuppressive regimen might be considered in the future, based on the study of certain polymorphisms or on immune status and alloreactivity determined by new biomarkers. Finally, the development of EBV and cmV vaccines would prevent these infections after transplantation. (C) 2011 Association Societe de Nephrologie. Published by Elsevier Masson SAS. All rights reserved.