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Pediatric Transplantation

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https://www.readbyqxmd.com/read/28213954/human-herpes-virus-6-infection-in-pediatric-organ-transplant-patients
#1
Elisa Ylinen, Silja Lehtinen, Timo Jahnukainen, Teemu Karlsson, Raisa Loginov, Laura Mannonen, Irmeli Lautenschlager, Hannu Jalanko
Transplant patients need lifelong immunosuppressive medication, but this reduces their defense mechanisms, making them prone to viral infections and reactivations. We aimed to clarify the prevalence and clinical manifestations of the human herpes virus 6 (HHV-6) infection in children after pediatric solid organ transplants. Clinical findings and viral loads were compared between primary HHV-6 infections and reactivations. The study comprised 47 kidney, 25 liver, and 12 heart transplant patients who underwent surgery from 2009 to 2014...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28213931/successful-resumption-of-peritoneal-dialysis-following-living-donor-liver-transplantation-in-children-with-end-stage-renal-disease
#2
Hiroyuki Kanazawa, Akinari Fukuda, Mai Sato, Shingo Ishimori, Kengo Sasaki, Hajime Uchida, Takanobu Shigeta, Vidyadhar Padmakar Mali, Seisuke Sakamoto, Kenji Ishikura, Mureo Kasahara
Children with ESRD in need of RRT are commonly managed by PD due to difficulty with vascular access for HD and the relatively large extracorporeal blood volume required. Major abdominal surgery may result in injury to the peritoneum and consequent adhesion, thereby resulting in a reduction in the anatomical capacity and transport capability across the peritoneal membrane. Here, we report successful resumption of PD after LDLT in two pediatric patients. The causes of ESRD were PH1 and juvenile nephronophthisis, respectively...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28211259/liver-transplantation-from-a-deceased-donor-with-%C3%AE-thalassemia-intermedia-is-not-contraindicated-a-case-report
#3
Ersin Gumus, Osman Abbasoglu, Cahit Tanyel, Fatma Gumruk, Hasan Ozen, Aysel Yuce
The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with β-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver...
February 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28205363/health-related-quality-of-life-after-combined-liver-and-kidney-transplantation-in-children
#4
Kaja Schmaeschke, Susanne Lezius, Enke Grabhorn, Markus J Kemper, Florian Brinkert
While reduced HRQOL following isolated organ transplantation has been previously reported, there are no data in the context of children following CLKT. Twenty-three children who underwent CLKT at our institution were included in the study. The indication for CLKT was PH1 in 13 patients and ARPKD in 10 patients. Quantification of HRQOL was facilitated through the use of the PedsQL 4.0 Generic Core Scale. The results of the study were compared to healthy children and published data of children who had undergone LTx or KTx...
February 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28198130/psychosocial-predictors-of-medication-adherence-in-pediatric-heart-and-lung-organ-transplantation
#5
Michael O Killian
Few studies have identified the psychosocial characteristics of those children and their families associated with future non-adherence to immunosuppressive medications following a heart or lung transplant. UNOS data and medical records information were used to test the association between patient and family psychosocial characteristics and medication adherence. Medication adherence outcomes were obtained using the physician assessments in the UNOS data and measured through patient-level standard deviation scores of immunosuppressive medication blood levels...
February 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28181361/a-systematic-review-of-parent-and-family-functioning-in-pediatric-solid-organ-transplant-populations
#6
REVIEW
Melissa K Cousino, Kelly E Rea, Kurt R Schumacher, John C Magee, Emily M Fredericks
The process of pediatric solid organ transplantation (SOT) places new and increased stressors on patients and family members. Measures of family functioning may predict psychological and health outcomes for pediatric patients and their families, and provide opportunity for targeted intervention. This systematic review investigated parent and family functioning and factors associated with poorer functioning in the pediatric SOT population. Thirty-seven studies were identified and reviewed. Studies featured a range of organ populations (eg, heart, liver, kidney, lung, intestine) at various stages in the transplant process...
February 8, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28181355/measures-of-and-changes-in-heart-rate-variability-in-pediatric-heart-transplant-recipients
#7
T Williams, X Tang, G Gilmore, J Gossett, K R Knecht
Heart rate variability is primarily regulated by the autonomic nervous system. Heart transplant recipients undergo surgical denervation of the graft, which results in interruption of autonomic innervation with resultant diminished heart rate variability although some degree of autonomic control may return. This study aimed to characterize heart rate variability in this population. We report a retrospective review of Holter monitor data from transplanted patients between 2005 and 2013. Studies with significant atrial or ventricular arrhythmias were excluded...
February 8, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28160362/globalization-of-pediatric-transplantation-the-risk-of-tuberculosis-or-not-tuberculosis
#8
Mignon McCulloch, Philana Ling Lin
The risk of TB among pediatric SOT recipients increases as the globalization of medical care continues to broaden. Unlike adults, children and especially infants are more susceptible to TB as a complication after transplantation. Little data exist regarding the true incidence of TB and the optimal risk-based management of this very vulnerable population. Here, we highlight the theoretical and practical issues that complicate the management of these patients and pose some questions that should be addressed when managing these patients...
February 3, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28160352/outcomes-of-children-adolescents-and-young-adults-following-allogeneic-stem-cell-transplantation-for-secondary-acute-myeloid-leukemia-and-myelodysplastic-syndromes-the-md-anderson-cancer-center-experience
#9
Ossama M Maher, Jorge Galvez Silva, Jimin Wu, Diane Liu, Laurence J N Cooper, Nidale Tarek, Laura Worth, Dean A Lee, Demetrios Petropoulos, Anna R K Franklin, Patrick Zweidler-Mckay, Robert J Wells, Gabriela Rondon, Richard E Champlin, Priti Tewari
We conducted a retrospective analysis of outcomes for children and young adults with sAML/sMDS who underwent HSCT at our institution. Thirty-two patients (median age 20 years) with sAML (n=24) and sMDS (n=8) received HSCT between 1990 and 2013. The median time from sAML/sMDS diagnosis to HSCT was 4.1 months (range: 1.2-27.2 months). The transplant regimens were primarily busulfan based (n=19). BM was the primary donor source (n=15). Eleven recipients were transplanted with residual disease. At a median follow-up of 62...
February 3, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28145625/pediatric-renal-transplant-practices-in-india
#10
Sidharth Kumar Sethi, Rajiv Sinha, Smriti Rohatgi, Vijay Kher, Arpana Iyengar, Arvind Bagga
Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India...
February 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28145624/severe-intellectual-disability-is-not-a-contraindication-to-kidney-transplantation-in-children
#11
Ashton Chen, Alan Farney, Gregory B Russell, Linda Nicolotti, Robert Stratta, Jeffrey Rogers, Jen-Jar Lin
Renal transplantation in children with ID is controversial. Acceptability of these children as candidates varies between programs. Limited outcome data in pediatric renal TXP recipients with cognitive impairment diminish their access to TXP. A retrospective chart review was performed of all children who underwent renal transplantation between January 1, 2002 and June 30, 2012 (N=72). Patients were divided into two groups, those with ID prior to transplantation (n=10) and those without (non-ID; n=62). Graft survival and BPAR episodes were compared between the two groups using Kaplan-Meier estimates...
February 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28145615/experiences-of-adolescent-lung-transplant-recipients-a%C3%A2-qualitative-study
#12
S M Anderson, J Wray, A Ralph, H Spencer, T Lunnon-Wood, K Gannon
Many young transplant recipients experience psychological distress and adjustment difficulties, yet there is little research investigating lung transplantation from the recipients' perspective. This qualitative study aimed to explore experiences of young people who underwent lung transplantation. Semi-structured interviews were conducted with six lung transplant recipients (aged 15-18). Interviews were analysed using IPA, a qualitative research approach examining how people make sense of their major life experiences...
February 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28134467/late-cytomegalovirus-infection-in-children-high-incidence-of-allograft-rejection-and-hepatitis-in-donor-negative-and-seropositive-liver-transplant-recipients
#13
A Verma, K Palaniswamy, G Cremonini, N Heaton, A Dhawan
The complications and outcome associated with late CMV infection and disease on the graft are poorly characterized in PLT recipients. We studied the overall incidence, risk factors, and outcome of late CMV infection and disease (infection 6 months after transplant) in 180 PLT recipients admitted between 2008 and 2011 at the King's College Hospital. Antiviral prophylaxis of intravenous ganciclovir was given only to the D+R- group starting at day 7 post-transplant. The remaining groups (D-R+, D+R+, and D-R-) received pre-emptive therapy when they have CMV viremia above cut-off value and treatment for symptomatic CMV infection...
January 30, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28133940/outcomes-of-pediatric-living-donor-kidney-transplantation-a%C3%A2-single-center-experience
#14
Sonia Pérez-Bertólez, Rafael Barrero, Julia Fijo, Verónica Alonso, Devicka Ojha, Miguel Ángel Fernández-Hurtado, Jerónimo Martínez, Eduardo León, Francisco García-Merino
Renal transplantation is the treatment of choice for children with ESRD offering advantages of improved survival, growth potential, cognitive development, and quality of life. The aim of our study was to compare the outcomes of LDKT vs DDKT performed in children at a single center. Retrospective chart review of pediatric patients who underwent kidney transplantation from 2005 to 2014 was performed. Ninety-one renal transplants were accomplished, and 31 cases (38.27%) were LDKT, and in 96.7% of the cases, the graft was obtained through laparoscopy...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28133935/post-transplant-immune-complex-nephritis-in-a-patient-with-systemic-lupus-erythematosus-associated-with-anca-vasculitis
#15
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28133856/on-exactitude-in-research
#16
LETTER
Rafael T Krmar
No abstract text is available yet for this article.
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28127842/hepatocarcinogenesis-in-multidrug-resistant-p-glycoprotein-3-deficiency
#17
Mukul Vij, Naresh P Shanmugam, Mettu Srinivas Reddy, Sanjay Govil, Mohamed Rela
MDR3 is a hepatocyte canalicular membrane protein encoded by the ABCB4 gene located on chromosome 7. MDR3 mediates the translocation of phosphatidylcholine into bile. Severe MDR 3 deficiency typically presents during early childhood with chronic cholestasis evolving to cirrhosis and portal hypertension, requiring liver transplantation. Herein, we report a case of severe MDR3 deficiency in a male child diagnosed with negative MDR3 immunostaining in hepatic canaliculi who underwent LDLT at our centre. We also describe single incidentally detected early well-differentiated HCC in the explant liver...
January 27, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28121050/imaging-in-pediatric-renal-transplantation
#18
REVIEW
Maria Beatrice Damasio, Lil-Sofie Ording Muller, Giorgio Piaggio, Stephen D Marks, Michael Riccabona
Renal transplantation is the therapy of choice in children with ESKD. Radiological investigations are required in both pre- and post-transplant assessment, although there is paucity of both consensus-based statements and evidence-based imaging guidelines in pediatric renal transplantation. The phases of pediatric ESKD management that require imaging are pretransplantation recipient assessment and post-transplantation surveillance for detection of potential complications. We present suggestions for imaging algorithms for both pre- and post-transplant assessment in pediatric renal transplant recipients...
January 25, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28120553/what-makes-a-good-pediatric-transplant-lung-insights-from-in-vivo-lung-morphometry-with-hyperpolarized-3-he-magnetic-resonance-imaging
#19
Emily F Fishman, James D Quirk, Stuart C Sweet, Jason C Woods, David S Gierada, Mark S Conradi, Marilyn J Siegel, Dmitriy A Yablonskiy
Obtaining information on transplanted lung microstructure is an important part of the current care for monitoring transplant recipients. However, until now this information was only available from invasive lung biopsy. The objective of this study was to evaluate the use of an innovative non-invasive technique, in vivo lung morphometry with hyperpolarized ³He MRI-to characterize lung microstructure in the pediatric lung transplant population. This technique yields quantitative measurements of acinar airways' (alveolar ducts and sacs) parameters, such as acinar airway radii and alveolar depth...
January 24, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28111865/portal-vein-reconstruction-using-vein-grafts-in-pediatric-living-donor-liver-transplantation-current-status
#20
Tarek Abdelazeem Sabra, Hideaki Okajima, Atsushi Yoshizawa, Tatsuya Okamoto, Takayuki Anazawa, Shintaro Ygi, Koichiro Hata, Kentaro Yasuchika, Kojiro Taura, Etsuro Hatano, Toshimi Kaido, Shinji Uemoto
PV reconstruction is an important aspect of LDLT, with post-transplant outcomes depending on PV reconstruction methods. However, it is unclear whether the preferential selection of these techniques is dependent on preoperative recipient characteristics. This retrospective study assessed whether preoperative recipient factors differed in pediatric patients who did and did not receive VGs for PV reconstruction. Of 113 pediatric patients who underwent LDLT from January 2010 to July 2015, 31 (27%) underwent PV reconstruction with VGs and the other 82 (73%) without VGs...
January 22, 2017: Pediatric Transplantation
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