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Pediatric Transplantation

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https://www.readbyqxmd.com/read/30003636/prophylactic-recombinant-thrombomodulin-treatment-prevents-hepatic-sinusoidal-obstruction-syndrome-in-high-risk-pediatric-patients-that-undergo-hematopoietic-stem-cell-transplants
#1
Shohei Yamamoto, Daisuke Toyama, Yumiko Sugishita, Ryota Kaneko, Naoko Okamoto, Masaya Koganesawa, Sachio Fujita, Kosuke Akiyama, Ryosuke Matsuno, Keiichi Isoyama
Hepatic SOS is a potentially life-threatening complication of conditioning for allogeneic HSCT. rTM is a new drug for treating DIC. We report our experience of the use of rTM as a prophylaxis against SOS in high-risk pediatric patients that underwent HSCT. We evaluated the cases of 19 pediatric hematology and oncology patients who underwent HSCT at our institution between 2007 and 2016. The patients who received HSCT after 2012 (n = 8) were treated with rTM as a prophylaxis against SOS together with UDCA and LMWH, whereas the others (n = 11) were only treated with UDCA and LMWH...
July 12, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/30003623/recurrent-oral-ulcerations-following-heart-transplant-in-a-pediatric-patient-a-diagnostic-dilemma
#2
Namir Asmar, Ashley V Geerlinks, Ronald M Laxer, Shirley M L Tse, Anne Dipchand, Angela Punnett
Oral ulceration is a non-specific clinical finding with many potential causes. The persistence of oral ulcers in the context of a patient post-SOT is concerning for PTLD. There is growing evidence that SOT recipients may also be at higher risk of autoimmune diseases. This case report describes a pediatric patient with persistent oral ulcers after heart transplant, who underwent an extensive workup for PTLD, including repeat investigations, with a subsequent diagnosis of Behçet's disease.
July 12, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/30003622/ex-vivo-liver-resection-and-autotransplantation-with-cardiopulmonary-bypass-for-hepatoblastoma-in-children-a-case-report
#3
Shu-Jun Shi, Deng-Liang Wang, Wei Hu, Fei Peng, Quan Kang
Some primary and secondary liver carcinomas cannot be resected using a conventional approach due to their size, location, or major vascular invasion. The aim of this study was to explore the application of ex vivo liver resection and autotransplantation for complicated HB in children. A 1.5-year-old girl with HB after repeated chemotherapy was analyzed. In this patient, tumor invasion includes the IV, V, and VIII liver segments, and thrombosis formed in the inferior vena cava and right atrium. It is difficult to obtain complete tumor resection using conventional hepatectomy...
July 12, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29992714/outcome-of-treosulfan-based-reduced-toxicity-conditioning-regimens-for-hsct-in-high-risk-patients-with-primary-immune-deficiencies
#4
Şule Haskoloğlu, Sevgi Köstel Bal, Candan İslamoğlu, Demet Altun, Tanıl Kendirli, Esin Figen Doğu, Aydan İkincioğulları
INTRODUCTION: HSCT is the curative therapeutic option in PIDs. Due to the increase in survival rates, reduced-toxicity conditioning regimens with treosulfan have become another alternative. The purpose of this retrospective study was to analyze the outcome of treosulfan-based conditioning before HSCT for patients with PID. METHOD: A total of 15 patients that received a treosulfan-based conditioning regimen for HSCT were recruited. Type of diagnosis, donor and stem cell source, pretransplant organ damage, infections, engraftment, chimerism, and transplant-related toxicities were analyzed...
July 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29992708/the-impact-of-donor-recipient-age-difference-and-hla-mismatch-on-graft-outcome-in-pediatric-kidney-transplantation
#5
Peter Trnka, Steven J McTaggart, Anna Francis
BACKGROUND: Understanding the relationship between the factors that influence long-term kidney transplant survival remains a key priority for pediatric nephrologists. We assessed the relative impact of donor/recipient age difference and HLA matching on long-term graft outcomes. METHODS: We conducted a retrospective cohort study of pediatric and adolescent recipients who received a primary kidney transplant in Australia and New Zealand between January 1, 1990, and December 31, 2015...
July 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29992703/transcatheter-stenting-of-superior-vena-cava-obstruction-after-pediatric-heart-transplantation-a-single-center-experience-assessing-risk-factors-and-outcomes
#6
Arash Salavitabar, Jonathan N Flyer, Alejandro J Torres, Marc E Richmond, Matthew A Crystal, Mariel E Turner, Paul Chai, Warren A Zuckerman
Transcatheter stent implantation for SVC obstruction following OHT has been well described, particularly in pediatric patients. This study describes a large single-center pediatric heart transplant experience that investigates the risk factors for SVC stenosis requiring stent implantation and its associated outcomes. All pediatric OHTs between January 1, 2000, and December 12, 2016, were examined for risk factors. Twelve of 349 (3.4%) OHTs required SVC stent implantation. Patients who required stents were younger (2...
July 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29992675/a-3-year-longitudinal-study-of-skeletal-effects-and-growth-in-children-after-kidney-transplantation
#7
Diana Swolin-Eide, Sverker Hansson, Per Magnusson
This prospective study investigated growth and skeletal development for 3 years after kidney transplantation in pediatric patients, 3.4-15.0 years of age. Growth, BMD, bone resorption markers (CTX and TRACP5b), bone formation markers (PINP, ALP, and osteocalcin), PTH, and vitamin D were assessed at start, 3, 12, and 36 months after transplantation. Median GFR was 63 (range 37-96) mL/min/1.73 m2 after 3 years. The median height SDS increased from -1.7 to -1.1, and median BMI SDS increased from -0.1 to 0...
July 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29927031/fecal-pancreatic-elastase-1-in-the-evaluation-of-pancreatic-function-after-pediatric-intestinal-transplantation
#8
Stuart S Kaufman, Xiaogang Simon Zhong, Ahmed M Elsabbagh, Dominique Bailey, Nada A Yazigi, Khalid M Khan, Cal S Matsumoto
Fat malabsorption is common after SBT. To identify whether anatomic variant transplants differ in occurrence of exocrine pancreatic insufficiency that could contribute to fat malabsorption, we measured FPE repeatedly in 54 recipients of a SBT, ages 6.2 to 320 months. FPE determination most distant from SBT was 6.1 years. Of the 54, 39% received an isolated intestinal graft (native pancreas only), 48% received an en bloc liver-intestinal-pancreas graft (native and graft pancreas), and 13% received a multivisceral graft (graft pancreas only)...
June 21, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29923335/cecum-perforation-induced-by-mycophenolate-mofetil-after-hematopoietic-stem-cell-transplantation-a-case-report-and-review-of-literature
#9
Barbaros Sahin Karagun, Tugana Akbas, Taner Arpaci, Bulent Antmen
GI perforation after stem cell transplantation is extremely rare and is associated with poor prognosis. In addition, the clinical limitations of MMF are associated with GI intolerance and hematologic suppression. However, the exact mechanism whereby MMF induces changes in GI mucosa is unknown. Currently, there is no definite method to distinguish between GI toxicity associated with MMF and GVHD. It is important to recognize association between MMF and the histologic changes mimicking GVHD, given that GVHD is a significant differential diagnosis in stem cell transplant patients...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29923253/comparison-of-survival-outcome-between-donor-types-or-stem-cell-sources-for-childhood-acute-myeloid-leukemia-after-allogenic-hematopoietic-stem-cell-transplantation-a-multicenter-retrospective-study-of-study-alliance-of-yeungnam-pediatric-hematology-oncology
#10
Ye Jee Shim, Jae Min Lee, Heung Sik Kim, Nani Jung, Young Tak Lim, Eu Jeen Yang, Jeong Ok Hah, Young-Ho Lee, Hee Won Chueh, Jae Young Lim, Eun Sil Park, Jeong A Park, Ji Kyoung Park, Sang Kyu Park
We compared transplant outcomes between donor types and stem cell sources for childhood acute myeloid leukemia (AML). The medical records of children with AML in the Yeungnam region of Korea from January 2000 to June 2017 were reviewed. In all, 76 children with AML (male-to-female ratio = 46:30) received allogenic hematopoietic stem cell transplantation (allo-HSCT). In total, 29 patients received HSCT from either a matched-related donor or a mismatched-related donor, 32 patients received an unrelated donor, and 15 patients received umbilical cord blood...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29921021/hepatosplenic-%C3%AE-%C3%AE-t-cell-lymphoma-of-two-adolescents-case-report-and-retrospective-literature-review-in-children-adolescents-and-young-adults
#11
Sheila S McThenia, Jawhar Rawwas, Jennifer L Oliveira, Shakila P Khan, Vilmarie Rodriguez
HSTCL is a highly aggressive malignancy with a poor prognosis. Case series and accounts have reported the use of different chemotherapy regimens with diverse patient outcomes. Most long-term survivors had undergone high-dose chemotherapy with autologous or allogeneic HCT. We describe two pediatric patients with HSTCL who were treated with chemotherapy followed by allogeneic HCT. Both patients are alive and in complete remission 2 and 8 years after therapy. Multiagent chemotherapy followed with allogeneic HCT seems to provide patients who have chemotherapy-sensitive disease a long-term disease-free survival...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29921011/selective-t-cell-depleted-haploidentical-hematopoietic-stem-cell-transplantation-for-relapsed-refractory-neuroblastoma
#12
Anthony P Y Liu, Pamela P W Lee, Janette S Y Kwok, Rock Y Y Leung, Alan K S Chiang, Shau-Yin Ha, Daniel K L Cheuk, Godfrey C F Chan
Relapsed/refractory NB carries a bleak outcome, warranting novel treatment options. HaploHSCT induces a graft-versus-NB effect via natural killer cell alloreactivity. Review of patients with relapsed/refractory NB who underwent haploHSCT with ex vivo T-cell depletion in our unit from 2013 through 2018. Ten patients were identified (male=5; median age at haploHSCT=6.45 y, range: 3.49-11.02 y). Indications were relapsed in 7 and refractoriness in 3; disease status at haploHSCT was CR in 2, PR in 6, and PD in 2...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29921004/small-effort-high-impact-focus-on-physical-activity-improves-oxygen-uptake-vo-2peak-quality-of-life-and-mental-health-after-pediatric-renal-transplantation
#13
Hjørdis Thorsteinsdottir, Trond H Diseth, Anine Lie, Trine Tangeraas, Iren Matthews, Anders Åsberg, Anna Bjerre
This study estimates the effects on peak oxygen uptake (VO2 peak ), QoL, and mental health after the introduction of an adjusted post-transplant follow-up program, that is, early physiotherapy and focus on the importance of physical activity. VO2 peak was measured by a treadmill exercise test in 20 renal-transplanted children on the adjusted post-transplant follow-up and compared with a group of 22 patients investigated in a previously, before the implementation of our new follow-up routines. PedsQL and The Strengths and Difficulties Questionnaire (SDQ) were used to assess QoL and mental health in 45 patients on the new as compared to 32 patients on the previous follow-up strategy...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29920882/education-enjoyment-and-empowerment-outcomes-of-an-adolescent-transplant-camp-i-own-it
#14
Keerthana Kesavarapu, Sirish K Palle, Molly Dugan, Shannon Antinerella, Shannon Luetkemeyer, Nitika Gupta
Peer group camping experiences have a positive influence on adolescents with chronic illnesses, but the data in solid organ transplant recipients are lacking. The aim of this study was to evaluate the outcomes of adolescent transplant attendees of an educational camp. A weekend camp, "I own it" was organized which provided educational training regarding career and health choices, money matters, and managing medications following which a knowledge assessment was performed. The ACLSA questionnaire was also administered...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29920880/effect-of-cyp3a5-1-expression-on-tacrolimus-required-dose-for-transplant-pediatrics-a-systematic-review-and-meta-analysis
#15
REVIEW
Fatemeh Hendijani, Negar Azarpira, Maryam Kaviani
This systematic review was designed to find out optimal tacrolimus dose in pediatrics according to their CYP3A5*1 genotype by performing meta-analysis. PubMed, Scopus, ISI web of Science, ProQuest, Cochrane library, and clinicaltrail.gov were systematically searched to find studies in which tacrolimus dose and/or blood concentration and/or concentration-to-dose (C/D) ratio were determined in genotype groups of CYP3A5*1 in pediatric population. Data were extracted at 14 time points post-transplantation and meta-analysis of mean and SD was performed...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29920879/cell-phone-support-to-improve-medication-adherence-among-solid-organ-transplant-recipients
#16
Caitlin S Sayegh, Jacqueline R Szmuszkovicz, Jondavid Menteer, Sara Sherer, Daniel Thomas, Rachel Lestz, Marvin Belzer
For many adolescent and young adult solid organ transplant recipients, medication non-adherence is a mortal issue. This study investigated the feasibility, acceptability, and potential efficacy of a 12-week cell phone support intervention to improve immunosuppressant medication adherence. A small sample (N = 8) of non-adherent adolescent and young adult transplant recipients, aged 15-20.5 years, was enrolled. Cell phone support consisted of short calls each weekday including medication reminders, discussion of needs, problem-solving support, and promotion of clinic and community resources...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29908011/pretransplant-increases-in-left-ventricular-volume-and-mass-are-associated-with-qt-prolongation-during-pediatric-liver-transplantation
#17
Hyun-Seok Cho, Wook-Jong Kim, Byungdoo Andrew Lee, Junki Cho, Won-Jung Shin, Gyu-Sam Hwang
Structural alterations in the cirrhotic heart may contribute to electromechanical abnormalities, represented by QT prolongation. The aim of this study was to investigate the changes in QTc according to the operative stage during pediatric LT and to identify which baseline echocardiographic parameters were associated with intraoperative QTc prolongation. Data were evaluated from 39 children undergoing LT for chronic liver disease (median age 9 months). In 19 patients (48.7%), baseline QTc was prolonged ≥440 ms (462 ± 19 ms)...
June 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29907993/comparison-of-histidine-tryptophan-ketoglutarate-and-university-of-wisconsin-preservation-solutions-in-pediatric-liver-transplantation
#18
Richard S Mangus, Joel R Schroering, Taylor J Hathaway, Chandrashekhar A Kubal, Jonathan A Fridell
UW and HTK solutions are the two primary organ preservation solutions most used in the United States. This study analyzes use of the two solutions in all pediatric liver transplants performed at a single center between 2001and 2017. Outcome measures included early graft function, as well as graft and patient survival. Bile duct complications were reviewed. Operative technique, immunosuppressive protocols, and donor acceptance criteria remained uniform among participating surgeons throughout the study period...
June 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29888545/long-term-outcomes-of-liver-transplantation-for-hepatoblastoma-a-single-center-14-year-experience
#19
Gabriel Ramos-Gonzalez, Michael LaQuaglia, Allison F O'Neill, Scott Elisofon, David Zurakowski, Heung Bae Kim, Khashayar Vakili
HB is the most common primary liver tumor in children. Complete tumor excision, either by partial resection or by total hepatectomy and liver transplantation, in combination with chemotherapy provides the best chance for cure. We performed a retrospective analysis of patients who underwent liver transplantation for HB and herein present our 14-year single-institution experience. Twenty-five patients underwent liver transplantation for HB at a median age of 26 months (IQR: 15-44). Graft survival was 96%, 87%, and 80% at 1, 3, and 5 years, respectively...
June 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29888518/epidemiology-and-outcomes-of-pretransplant-methicillin-resistant-staphylococcus-aureus-screening-in-pediatric-solid-organ-transplant-candidates
#20
Grant Paulsen, Samantha Blum, Lara Danziger-Isakov
MRSA infection following SOT is an important cause of morbidity and mortality, but epidemiology and risk factors for colonization prior to pediatric SOT remain unclear. A retrospective cohort of SOT patients ≤21 years of age from 2009 to 2014 was evaluated. Demographics, MRSA screens, timing of transplantation, and MRSA infection were abstracted. From 2013 to 2014, 130 SOT candidates were screened or had known prior MRSA infection. Seventeen patients (13%) were MRSA colonized. Liver transplant candidates were least likely to be colonized (OR 0...
June 11, 2018: Pediatric Transplantation
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