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Pediatric Transplantation

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https://www.readbyqxmd.com/read/29457852/successful-management-of-living-donor-liver-transplantation-for-biliary-atresia-with-single-ventricle-physiology-from-peri-transplant-through-total-cavopulmonary-connection-a-case-report
#1
Yohei Yamada, Ken Hoshino, Takayuki Oyanagi, Ryohei Gatayama, Jun Maeda, Nobuyuki Katori, Yasushi Fuchimoto, Taizo Hibi, Masahiro Shinoda, Kentaro Matsubara, Hideaki Obara, Ryo Aeba, Yuko Kitagawa, Hiroyuki Yamagishi, Tatsuo Kuroda
Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology...
February 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29453832/living-donor-liver-transplantation-for-mild-zellweger-spectrum-disorder-up-to-17-years-follow-up
#2
Tanguy Demaret, Sharat Varma, Xavier Stephenne, Françoise Smets, Isabelle Scheers, Ronald Wanders, Lionel Van Maldergem, Raymond Reding, Etienne Sokal
Mild Zellweger spectrum disorder, also described as Infantile Refsum disease, is attributable to mutations in PEX genes. Its clinical course is characterized by progressive hearing and vision loss, and neurodevelopmental regression. Supportive management is currently considered the standard of care, as no treatment has shown clinical benefits. LT was shown to correct levels of circulating toxic metabolites, partly responsible for chronic neurological impairment. Of three patients having undergone LT for mild ZSD, one died after LT, while the other two displayed significant neurodevelopmental improvement on both the long-term (17 years post-LT) and short-term (9 months post-LT) follow-up...
February 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29453811/multimodal-treatment-including-tandem-high-dose-chemotherapy-and-autologous-stem-cell-transplantation-in-children-with-anaplastic-ependymomas
#3
Ji Won Lee, Do Hoon Lim, Ki Woong Sung, Hyeong Jin Lee, Eun Sang Yi, Keon Hee Yoo, Hong Hoe Koo, Yeon-Lim Suh, Hyung Jin Shin
In this study, we evaluated the results of multimodal treatment that included tandem HDCT/auto-SCT in children with anaplastic ependymomas. Fourteen patients with anaplastic ependymomas were enrolled from 2006 to 2014. Six cycles of induction chemotherapy were administered to all patients before they underwent tandem HDCT/auto-SCT. Patients who were older than 3 years of age were administered RT after two cycles of induction chemotherapy. In patients under 3 years of age, RT was either omitted or delayed until they reached 3 years of age, if the patients experienced CR after tandem HDCT/auto-SCT...
February 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29453782/unusual-spontaneous-porto-systemic-shunt-the-importance-of-diagnosing-non-anatomical-porto-systemic-shunts-to-improve-portal-flow-in-pediatric-living-related-liver-transplantation-case-report
#4
Juan S Rubio, Carolina Rumbo, Pablo A Farinelli, Nicolás Aguirre, Diego A Ramisch, Hugo Paladini, Pablo D Angelo, Pablo Barros Schelotto, Gabriel E Gondolesi
Collateral circulation secondary to liver cirrhosis may cause the development of large PSSs that may steal flow from the main portal circulation. It is important to identify these shunts prior to, or during the transplant surgery because they might cause an insufficient portal flow to the implanted graft. There are few reports of "steal flow syndrome" cases in pediatrics, even in biliary atresia patients that may have portal hypoplasia as an associated malformation. We present a 12-month-old female who received an uneventful LDLT from her mother, and the GRWR was 4...
February 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29441655/the-importance-of-cardiovascular-disease-in-pediatric-transplantation-and-its-link-to-the-kidneys
#5
REVIEW
Jonathan N Johnson, Guido Filler
Cardiovascular disease is a frequent cause of morbidity and mortality in pediatric patients following solid organ transplant. CKD is also common in pediatric patients after a solid organ transplant, and the link between CKD and cardiovascular morbidity is strong. In this review, we examine potential etiologies to explain the risk of cardiovascular morbidity and mortality in pediatric solid organ recipients and identify targets for improving outcomes.
February 13, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29441651/invasive-pneumococcal-infections-in-pediatric-liver-small-bowel-pancreas-transplant-recipients
#6
Hanh D Vo, Diana F Florescu, Cindy R Brown, Heather E Chambers, David F Mercer, Luciano M Vargas, Wendy J Grant, Alan N Langnas, Ruben E Quiros-Tejeira
Children undergoing LSBPTx are at increased risk of IPI due to splenectomy. We aimed to describe the clinical features and outcomes of IPI in pediatric LSBPTx recipients. Between 2008 and 2016, 122 LSBPTx children at our center were retrospectively reviewed. Nine patients had 12 episodes of IPI; the median age at first infection was 3.5 years (range: 1.5-7.1 years). The median time from transplant to first infection was 3 years (range: 0.8-5.8 years). Clinical presentation included as follows: pneumonia (n = 1), bacteremia/sepsis (n = 7), pneumonia with sepsis (n = 1), meningitis with sepsis (n = 2), pneumonia and meningitis with sepsis (n = 1)...
February 13, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29430795/pediatric-renal-transplantation-a-retrospective-single-center-study-on-epidemiology-and-morbidity-due-to-ebv
#7
A Laurent, A Klich, P Roy, B Lina, B Kassai, J Bacchetta, P Cochat
Pediatric R-Tx patients are at high risk of developing EBV primary infection. Although high DNA replication is a risk factor for PTLD, some patients develop PTLD with low viral load. In this retrospective single-center study including all pediatric patients having received R-Tx (2003-2012 period), we aimed to identify risk factors for uncontrolled reactions to EBV (defined as the presence of a viral load >10 000 copies/mL or PTLD). A Cox proportional hazard model was performed. A total of 117 patients underwent R-Tx at a mean age of 9...
February 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29417707/increased-carotid-intima-media-thickness-in-african-american-pediatric-kidney-transplant-recipients
#8
Kristen Sgambat, Sarah Clauss, K Y Lei, Juizhou Song, Shaik O Rahaman, Margaret Lasota, Asha Moudgil
Early signs of subclinical CV dysfunction can be detected by ultrasound for CIMT. Although A-A are at high risk for CV disease, CIMT of A-A kidney transplant recipients has not been previously investigated. The aim of this prospective, controlled, longitudinal study was to investigate determinants of CIMT in a multiracial pediatric kidney transplant population, with a focus on A-A. Transplant recipients (n = 42) had BMI, waist-to-height ratio, fasting glucose, lipid panel, HbA1c%, and CIMT measured at 1, 18, and 30 months post-transplant...
February 8, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29417695/visual-perceptual-skills-and-visual-motor-integration-in-children-and-adolescents-after-allogeneic-hematopoietic-stem-cell-transplantation
#9
Kristina Teär Fahnehjelm, Alba Lucia Törnquist, Monica Olsson, Jacek Winiarski, Ulla Ek
The aim of the study was to study visual acuity, visual perceptual, and VMI skills in patients after HSCT in childhood. Tests of visual perceptual skills, VMI, and visual acuity were performed in 102 children/adolescents (age range 4.3-20.9 years). Mean time from HSCT to testing was 6.0 years (0.9-17.5 years). Visual acuity was median 1.0 decimal (range 0.16-1.6). Visual perceptual skills (memory, form constancy, visual sequential memory) and VMI were low compared to age-equivalent normative data with, respectively, 36%, 45%, 60%, and 46% of all patients performing below the 25 percentile...
February 8, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29417722/is-there-a-case-for-eculizumab-for-pediatric-renal-transplantation
#10
EDITORIAL
Guido Filler, Christoph Licht, Shih-Han Susan Huang
No abstract text is available yet for this article.
February 7, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29417691/incidence-risk-factors-and-outcomes-related-with-neurological-events-after-liver-transplantation-in-adult-and-pediatric-recipients
#11
Federico Piñero, Yu Cheang, Manuel Mendizabal, Joaquín Cagliani, Ariel Gonzalez Campaña, Josefina Pages, Carla Colaci, Mariano Barreiro, Cristina Alonso, Ivone Malla, Martín Fauda, Jose Bueri, Luis G Podesta, Marcelo Silva
Controversy exists whether NE after LT are more frequently observed in children or adults. We aimed to compare the incidence and outcomes for NE after LT in pediatric and adult recipients. A single-center cohort study, including all LT between 2001 and 2013, was performed. Definition of NE included impaired consciousness, delirium, seizures, focal neurologic deficit, visual impairment, or slurred speech. A cohort of 443 consecutive LT recipients was included: 307 adults and 136 children. Cumulative incidence of NE was similar between adults 15% (n = 41) and children 16% (n = 20; P = ...
February 7, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29417689/efficacy-of-high-dose-steroids-for-bronchiolitis-obliterans-syndrome-post-pediatric-hematopoietic-stem-cell-transplantation
#12
Ehud Even-Or, Hasan Ghandourah, Muhammad Ali, Joerg Krueger, Neil B Sweezey, Tal Schechter
BOS is the pulmonary manifestation of cGvHD post-allogeneic HSCT. Survival and treatment of this often fatal complication have not improved over the last 20 years and there is no clear standard of care. For the past 10 years, BOS was treated in our center with monthly cycles of HDPS. We reviewed the outcomes of patients with post-HSCT BOS who met the diagnostic criteria for BOS as per the NIH consensus and were treated with at least one cycle of methylprednisolone at a dose of 10-30 mg/kg/d×3 d. We collected demographic and clinical data, responses to treatment and results of pulmonary function tests at several time points...
February 7, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29411474/epidemiology-and-outcome-of-chronic-high-epstein-barr-viral-load-carriage-in-pediatric-kidney-transplant-recipients
#13
Masaki Yamada, Christina Nguyen, Paul Fadakar, Armando Ganoza, Abhinav Humar, Ron Shapiro, Marian G Michaels, Michael Green
The development of EBV infection and PTLD is normally associated with a high EBV viral load in peripheral blood. Observations have previously identified existence of a CHL carrier state that demonstrated variable outcomes based upon the organ which was transplanted. Data defining the incidence and outcome of CHL in pediatric KTx are not well described. The charts of children undergoing isolated KTx at Children's Hospital of Pittsburgh between January 2000 and December 2014 were retrospectively reviewed. EBV loads in the peripheral blood were routinely measured as part of surveillance protocols at our center...
February 6, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29399926/the-choice-between-deceased-vs-living-donor-renal-transplantation-in-children-analysis-of-data-from-a-belgian-tertiary-center
#14
Katty Van Cauwenberghe, Ann Raes, Lut Pauwels, Jo Dehoorne, Luc Colenbie, Clement Dequidt, Lien Dossche, Johan Vande Walle, Agnieszka Prytuła
Pediatric renal transplantation with a living donor (LD) has superior outcome, but there is a paucity of studies analyzing the reasons for not undertaking living donation in West-European countries. The aim of this study was to retrospectively review the choice of donor source in our center. We also aimed to identify factors which prevented transplantation with a LD. This retrospective study was performed including children aged 2-19 years who underwent kidney transplantation (KT) at the Ghent University Hospital between 1996 and 2016...
February 4, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29396905/transplant-related-mortality-and-survival-in-children-with-malignancies-treated-with-allogeneic-hematopoietic-stem-cell-transplantation-a-multicenter-analysis
#15
Agnieszka Zaucha-Prazmo, Jolanta Gozdzik, Robert Debski, Katarzyna Drabko, Elzbieta Sadurska, Jerzy R Kowalczyk
The aim of the study was to assess the risk of TRM in pediatric patients treated for malignant disorders with allogeneic HSCT, according to different risk factors. The treatment outcome was analyzed in 299 pediatric patients treated in pediatric transplant departments from 2006 to 2015. To compare the outcome, patients were analyzed all together and in groups according to the diagnosis, age at transplant, donor type, disease status, stem cell source, and pediatric TRM score. At the end of the observation time, 82 patients were alive, 82 died, of which 40 due to transplant-related reasons...
February 3, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29396892/diastolic-pressure-indices-offer-a-novel-approach-to-predicting-risk-of-graft-loss-after-pediatric-heart-transplant
#16
Erin L Albers, Miranda C Bradford, Joshua M Friedland-Little, Borah J Hong, Mariska S Kemna, Jonathan M Chen, Yuk M Law
PH is a risk factor for GL after HTx. However, traditional parameters are not reliable predictors of risk in children. We hypothesized that DPI (dPAP and DPG) are predictive of GL in pediatric HTx recipients. The UNOS/SRTR database was reviewed to identify pediatric HTx recipients (age <18 years) between 1994 and 2013. Recipients with pretransplant hemodynamic data were grouped by diagnosis (CMP or CHD), and the groups were analyzed separately. Bivariate Cox regression analysis examined the association between hemodynamic variables and GL...
February 3, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29392867/impact-of-center-volume-and-the-adoption-of-laparoscopic-donor-nephrectomy-on-outcomes-in-pediatric-kidney-transplantation
#17
Jennifer M Burg, David L Scott, Kayvan Roayaie, Erin Maynard, John M Barry, C Kristian Enestvedt
Reports for pediatric kidney transplant recipients suggested better outcomes for ODN compared to LDN. Contemporary outcomes stratified by donor type and center volume have not been evaluated in a national dataset. UNOS data (2000-2014) were analyzed for pediatric living donor kidney transplant recipients. The primary outcome was GF; secondary outcomes were DGF, rejection, and patient survival. Live donor nephrectomies for pediatric recipients decreased 30% and transitioned from ODN to LDN. GF rates did not differ for ODN vs LDN (P = ...
February 2, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29388370/the-role-of-continuous-renal-replacement-therapy-in-the-management-of-acute-kidney-injury-associated-with-sinusoidal-obstruction-syndrome-following-hematopoietic-cell-transplantation
#18
Rupesh Raina, Ghada A Abusin, Prashant Vijayaraghavan, Jeffery J Auletta, Linda Cabral, Hasan Hashem, Beth A Vogt, Kenneth R Cooke, Rolla F Abu-Arja
Maintaining fluid balance, pre- and post-MA-HCT is essential and usually requires frequent administration of diuretics. Hepatic sinusoidal obstructive syndrome is potentially life-threatening, especially when associated with AKI and MOF. This study describes six patients who developed AKI-associated SOS and diuretic-resistant FO who subsequently underwent CRRT using standardized management guidelines for fluid balance post-HCT. Retrospective chart review was done for HCT patients between September 2011 and October 2013 at a tertiary care children's hospital...
February 1, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29388318/intravesicular-cidofovir-for-bk-hemorrhagic-cystitis-in-pediatric-patients-after-hematopoietic-stem-cell-transplant
#19
Jennifer H Foster, W Susan Cheng, Ngoc-Yen Nguyen, Robert Krance, Caridad Martinez
BK virus hemorrhagic cystitis is a complication of HCST. Response to IV cidofovir is unpredictable, and treatment carries risk of toxicity. We report the largest series of pediatric patients with BKHC after HSCT successfully treated with intravesicular cidofovir. There was no significant decrease in urine or plasma BK PCR. There was significant decrease in pain score on days 3 and 7, with associated decrease in morphine use. No patients experienced toxicities associated with IV cidofovir. Intravesicular cidofovir appears to be safe and effective for symptomatic treatment of BKHC in pediatric patients after HSCT...
February 1, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29388304/disseminated-fungal-infection-by-aureobasidium-pullulans-in-a-renal-transplant-recipient
#20
Hulya Nalcacioglu, Y Kamil Yakupoglu, Gurkan Genc, Nursen Belet, Sema Gulnar Sensoy, Asuman Birinci, Ozan Ozkaya
Renal transplant recipients are on long-term potent immunosuppressive therapy, which makes them highly vulnerable to opportunistic fungal infections. Dematiaceous, or dark-pigmented saprophytic fungi, are being increasingly seen as opportunistic pathogens of mycoses in immunosuppressed patients. One of these is Aureobasidium pullulans, which is a black yeast-like dematiaceous fungus found ubiquitously in the environment that can cause various opportunistic human infections. Most infections occur by traumatic inoculation, such as keratitis and cutaneous lesions; disseminated mycoses are very rare and occur only in severely immunocompromised patients...
February 1, 2018: Pediatric Transplantation
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