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Pediatric Transplantation

Aysenur Demirok, Claudia Ranzijn, Junior Lardy, Sandrine Florquin, Antonia Bouts
The necessity of post-transplant monitoring for donor-specific antibodies (DSAs) is unclear. This study evaluates the clinical relevance of post-transplantation donor-specific HLA antibodies in pediatric renal transplant recipients, aiming at better stratification of patients at risk of graft dysfunction and better recommendations for post-transplant monitoring. A cohort of 68 pediatric kidney recipients, involving 76 transplantations between 2004 and 2014, was studied retrospectively. All patients were screened for HLA antibodies at 1, 3, 6, and 12 months after transplantation and yearly thereafter...
January 11, 2019: Pediatric Transplantation
Vikas R Dharnidharka
No abstract text is available yet for this article.
January 11, 2019: Pediatric Transplantation
Seth A Hollander, Lisa M Schultz, Katelin Dennis, Amanda M Hollander, Sandra Rizzuto, Jenna M Murray, David N Rosenthal, Christopher S Almond
BACKGROUND: Malnutrition is common in pediatric heart failure and is associated with mortality. The effect of VAD support on malnutrition in children is unknown. We sought to compare the prevalence and severity of malnutrition at HT in children on VAD support vs OMT to inform decisions regarding support strategies. METHODS: Retrospective chart review involving all patients <18 years who underwent HT at Stanford between 1/1/2011 and 3/1/2018. Malnutrition diagnosis and severity were defined by ASPEN guidelines using the lowest age-adjusted z-score for weight (WAZ), height (HAZ), and BMI (BMIZ) when the patient was euvolemic...
January 9, 2019: Pediatric Transplantation
Yukihiro Sanada, Itsuki Naya, Takumi Katano, Yuta Hirata, Naoya Yamada, Noriki Okada, Yoshiyuki Ihara, Yasuharu Onishi, Koichi Mizuta
BACKGROUND: Intracranial and pulmonary vascular anomalies are well-known complications and causes of mortality in AGS; however, visceral artery anomalies are less commonly recognized. Herein, we present a retrospective analysis of our experience with pediatric LDLT that focuses on the current problems with and treatments for visceral artery anomalies in AGS after LDLT. METHODS: Between May 2001 and December 2017, 294 LDLTs were performed for 285 pediatric recipients...
January 9, 2019: Pediatric Transplantation
Clyde J Smith, Michael A McCulloch, Debbie-Ann Shirley, Thomas J L'Ecuyer
As heart transplantation demand is increasing without subsequent growth of the donor pool, need for expansion of acceptance criteria is paramount, particularly when considering critically ill, highly sensitized patients. We present a case report of a pediatric heart transplant recipient of an organ refused by 197 prior potential recipients due to the donor being infected with influenza virus. We perform a literature review of recent solid organ transplant cases from influenza-positive donors and conclude that the donor pool may be expandable by allowing donors with treatable infections to be included...
January 9, 2019: Pediatric Transplantation
Katie L Mowers, Kathleen E Simpson, Avihu Z Gazit, Pirooz Eghtesady, Charles E Canter, Chesney D Castleberry
BACKGROUND: PGD is a complication after heart transplantation (OHT) and a significant cause of mortality, particularly in infant recipients. Lack of standardized definition of PGD in the pediatric population makes the prevalence and magnitude of impact unclear. METHODS: ISHLT PGD consensus guidelines, which include inotrope scores and need for MCS, were applied retrospectively to 208 pediatric OHT recipients from a single institution from 1/2005-5/2016. PGD was defined as: moderate PGD-inotrope score >10 on postoperative day 1 (24-48 hours), and severe PGD-MCS within 24 hours (in the absence of detectable rejection)...
January 4, 2019: Pediatric Transplantation
Michelle Science, Nadia Akseer, Sandra Asner, Upton Allen
BACKGROUND: Respiratory syncytial virus (RSV) infection is associated with increased morbidity and mortality in immunocompromised patients. Our goal was to develop a framework for risk stratifying immunocompromised patients, including transplant patients, for RSV prophylaxis. METHODS: Risk factors for severe RSV disease in immunocompromised patients were identified in the literature and by an expert panel via survey. Experts assigned a probability of developing severe disease (0 to 100 scale) to the risk factors for each immunocompromised population...
January 3, 2019: Pediatric Transplantation
Ana M Gutierrez-Colina, Grace K Cushman, Cyd K Eaton, Lauren F Quast, Jennifer Lee, Kristin Loiselle Rich, Bonney Reed-Knight, Laura Mee, Rene Romero, Chad Y Mao, Roshan George, Ronald L Blount
The current cross-sectional, single-center study aimed to examine sleep quality in a sample of adolescents awaiting solid organ transplantation and to explore associations between sleep quality and both health-related quality of life and barriers to adherence. Thirty adolescents between the ages of 12 and 18 years (M age = 15.26, SD = 1.89) who were awaiting transplantation participated in this study. Participants completed measures of sleep quality, health-related quality of life, and barriers to adherence...
January 3, 2019: Pediatric Transplantation
Richard Kirk, Ryan J Butts, Anne I Dipchand
BACKGROUND: The first pediatric heart transplant died 5 hours after transplant and the case was published by Kantrowitz. There is no report of the first successful case in the medical literature, nor indeed the outcome of children transplanted prior to 1982. However, we recently discovered that children from this period were entered retrospectively into the ISHLT Registry when it began and they form the basis of this report. METHODS: A retrospective review of the ISHLT Thoracic Registry was undertaken for pediatric heart transplants prior to 1982...
January 1, 2019: Pediatric Transplantation
Rashmi D'Souza, Tassos Grammatikopoulos, Akhilesh Pradhan, Harry Sutton, Abdel Douiri, Mark Davenport, Anita Verma, Anil Dhawan
OBJECTIVES: Acute-on-chronic liver failure (ACLF) is an acute decompensation of cirrhosis complicated by other organ failure and is associated with increased mortality and morbidity. ACLF has not been studied in children with biliary atresia (BA), which is the commonest indication for pediatric liver transplantation (LT) worldwide. This study aims to evaluate ACLF and outcomes in children with BA while awaiting deceased donor LT. METHODS: This was a subanalysis of the dataset from a prospective cohort study of patients aged 0-18 years who underwent portoenterostomy for BA and were listed for LT at King's College Hospital, London, between 1999 and 2003...
December 30, 2018: Pediatric Transplantation
Jessica Diaz, Blanche Chavers, Srinath Chinnakotla, Priya Verghese
In this single-center retrospective study, we analyzed kidney transplant outcomes in nine pediatric patients with VACTERL [vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, limb abnormalities] association-making this the largest study of its kind. Of 743 pediatric kidney transplant recipients at our center (1980-2017), nine had documented diagnoses of VACTERL association. All nine had congenital anorectal malformations and renal anomalies, five had vertebral defects, and one had a bifid thumb and tracheoesophageal fistula...
December 30, 2018: Pediatric Transplantation
Zhe Liu, Wen-Yu Zhao, Lei Zhang, You-Hua Zhu, Li Zeng
RTx is currently the best treatment for children with ESRD. This study retrospectively analyzed the outcomes of growth after RTx using the pediatric-to-pediatric allocation strategy and some factors that may affect it. From March 2012 to August 2016, 8 en bloc and 38 single pediatric RTxs were performed at our center using organs from small pediatric deceased donors (weight < 15 kg). Growth before and after RTx was analyzed according to the height-for-age z-score at RTx, the 3-year follow-up, and adulthood and compared between the procedures...
December 28, 2018: Pediatric Transplantation
Irene Petersen, Janka Noelle, Angela Buchholz, Sylvia Kroencke, Monika Daseking, Enke Grabhorn
The aim of the study was to investigate the occurrence of fatigue in 100 pediatric liver transplant recipients aged 2-18 years and its impact on their health-related quality of life (HRQL). HRQL and fatigue were measured using the PedsQL 4.0 Inventory and the PedsQL Multidimensional Fatigue Scale, which encompasses three subscales: general fatigue, sleep/rest fatigue, and cognitive fatigue. The impact of the different domains of fatigue and of clinical and sociodemographic factors on the HRQL was identified with stepwise multiple regression analyses...
December 26, 2018: Pediatric Transplantation
Khaled Alsager, Saadia Waqar, Hina Furrukh, Nadia Alattas
S. stercoralis infection has been identified as a donor-derived infection in cases of solid organ transplant among recipients with no prior risk factor for parasitic exposure. Worldwide and regional reports from the adult kidney transplant population highlight this indirect method of infection and caution about delayed diagnosis, severe complications, and death related to donor-derived S. stercoralis infection. We report a deceased-donor-derived S. stercoralis infection in a 12-year-old Saudi girl who underwent kidney transplantation...
December 21, 2018: Pediatric Transplantation
Inês Pessanha, Henrique Alexandrino, Cláudia Piedade, Catarina Cunha, Isabel Gonçalves, Maria Francelina Lopes, Emanuel Furtado
INTRODUCTION: Gallbladder agenesis (GA) is a rare congenital condition, occurring in approximately 40/100.000. It is likely due to an embryologic mishap in the development of the gallbladder bud and can be associated with other congenital variations in biliary anatomy. However, the liver likely suffers no functional impairment and can be safely used for transplantation. To the best of our knowledge, this is the first case report describing a pediatric liver transplantation (PLT) using a graft with GA...
December 21, 2018: Pediatric Transplantation
Wing Yan Yuen, Ashley Tan, Sivaramakrishnan Venkatesh Karthik, Seng Hock Quak, Alfred Wei-Chieh Kow, Marion M Aw
PURPOSE: The understanding of the HRQOL issues for parent donors of children who underwent LDLT is lacking. We evaluated the HRQOL of donor and non-donor parents, described their subjective experiences and identified factors associated with lower HRQOL post-donation. METHODS: This is a cross-sectional study of parent donors whose children underwent LDLT, using SF-36v2 Health Survey to measure HRQOL, and a self-developed questionnaire to evaluate their subjective experiences...
December 19, 2018: Pediatric Transplantation
Aaron Wightman, Miranda C Bradford, Jodi Smith
BACKGROUND: Studies of HRQoL after kidney transplant have yielded conflicting results. We sought to assess the impact of kidney transplant on HRQoL. METHODS: We performed a retrospective study using the PedsQL3.0ESRD module during dialysis and at 3 and 12 months following kidney transplant in 56 recipients. For the entire cohort, we described HRQoL scores at each time point and used ANOVA models to test for associations between demographic and transplant-related factors and post-transplant scores...
December 12, 2018: Pediatric Transplantation
Tomáš Seeman, Karel Vondrák, Jiří Dušek
OBJECTIVES: Strict BP control can retard progression of CKD in children. This prospective 3-year randomized controlled trial is aimed to investigate whether strict BP control can retard progression of chronic allograft dysfunction. METHODS: Twenty-three pediatric patients were randomly selected to the standard BP group (STAND, target 24-hour MAP 50-95th percentile, n = 11) or the intensified BP group (INTENS, target 24-hour MAP <50th percentile, n = 12). The primary endpoint was an annual reduction in eGFR (Schwartz formula, mL/min/1...
December 9, 2018: Pediatric Transplantation
Yuan Sun, Zhouyang Liu, Juan Xiao, Xiaomei Liu, Fan Jiang, Shifen Fan, Ying Shen
OBJECTIVE: To investigate the efficacy of ACBT for acquired SAA in children. METHODS: Four patients including three girls and one boy were diagnosed with acquired SAA. Their ages were 5, 3, 1, and 3 years, respectively. Patients received an immunoablative preparative regimen using low-dose antithymocyte globulin, cyclophosphamide, and fludarabine. The unrelated human umbilical cord MSC were infused before the autologous cord blood was transfused on day 0. The first and second patients were not treated with immunosuppressive agents after transplantation...
December 9, 2018: Pediatric Transplantation
Justin Chen, Rochelle Liverman, Rouba Garro, Stephanie Jernigan, Curtis Travers, Pamela D Winterberg
INTRODUCTION: There are limited data to guide optimal treatment strategies for acute cellular rejection (ACR) based on Banff grade for pediatric kidney transplant recipients. This report reviews a large pediatric transplant center's experience with ACR. MATERIALS AND METHODS: A retrospective analysis of pediatric kidney transplant recipients at our center from 2007 to 2014 was performed. Primary outcomes were incidence of graft failure and graft function one year following ACR based on Banff grade and treatment received...
December 7, 2018: Pediatric Transplantation
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