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Pediatric Transplantation

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https://www.readbyqxmd.com/read/28510265/severity-and-outcome-of-the-norovirus-infection-in-children-after-intestinal-transplantation
#1
Marie Patte, Danielle Canioni, Véronique Avettand Fenoel, Pierre Frange, Marion Rabant, Cécile Talbotec, Florence Lacaille
In immunocompromised patients, the NoV infection is prolonged and severe. We retrospectively studied the severity of the NoV infection in children after an ITx, the treatment, and the long-term evolution. Norovirus PCR in stools was positive for 19 children in 21 separate episodes. The infection was symptomatic in 18 cases. At diagnosis, the median weight loss was 5% (0-11) and the creatinine clearance was 75 mL/min/1.73 m(2) (19-142). On 14 digestive biopsies, the pathological findings were non-specific with a constant mononuclear infiltration, showing signs of rejection in one case...
May 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28504342/sudden-death-in-a-pediatric-heart-transplant-recipient-with-peripheral-eosinophilia-and-eosinophilic-myocardial-infiltrates
#2
William McEachern, Justin Godown, Debra A Dodd, Anne I Dipchand, Jennifer L Conway, Gregory J Wilson, Robert D Hoffman
Eosinophilia has been rarely reported in pediatric heart transplant recipients and has been suggested to play a role in graft rejection. We report a case of a young female patient with peripheral blood eosinophilia who died suddenly 2 years following ABO-incompatible heart transplantation. She was found at autopsy to have myocardial infiltration of not only T-lymphocytes and macrophages expected in acute cellular rejection but also of eosinophils, B-lymphocytes, and plasma cells indicating myocarditis.
May 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28497658/toxic-epidermal-necrolysis-in-a-child-6-months-post-hematopoietic-stem-cell-transplantation
#3
Utako Oba, Hiroshi Yamada, So-Ichi Suenobu, Yusuke Nakamura, Akiko Ito, Yutaka Hatano, Nobuyoshi Itonaga, Kouichi Ohshima, Yuhki Koga, Shouichi Ohga, Kenji Ihara
TEN is a rare and critical disease mostly caused by drugs. It is mediated by activated CD8+ T cells that cause keratinocyte apoptosis with the assistance of cytokines/chemokines. We herein report a pediatric case of TEN after allogeneic HSCT with precursor B-cell acute lymphoblastic leukemia (pre-B-ALL) in second complete remission. Although we did not evaluate the T-cell subpopulation in blood or skin lesion of the patient, an imbalanced immune reconstitution after HSCT might additively contribute to the development of TEN...
May 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28497648/intrahepatic-cholangiojejunostomy-for-complex-biliary-stenosis-after-pediatric-living-donor-liver-transplantation
#4
Fernando A Alvarez, Rodrigo Sanchez Claria, Juan Glinka, Martin de Santibañes, Juan Pekolj, Eduardo de Santibañes, Miguel A Ciardullo
The treatment of biliary stenosis after pediatric LDLT is challenging. We describe an innovative technique of peripheral IHCJ for the treatment of patients with complex biliary stenosis after pediatric LDLT in whom percutaneous treatment failed. During surgery, the percutaneous biliary drainage is removed and a flexible metal stylet is introduced trough the tract. Subsequently, the most superficial aspect of the biliary tree is recognized by palpation of the stylet's round tip in the liver surface. The liver parenchyma is then transected until the bile duct is reached...
May 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28452096/kidney-transplant-after-hematopoietic-cell-transplant-in-pediatrics-infectious-and-immunosuppressive-considerations
#5
Christen L Ebens, Angela R Smith, Priya S Verghese
Pediatric patients requiring kidney transplant after hematopoietic cell transplant receive multiple courses of immunosuppression placing them at risk for infection. To elucidate potential risk factors for infection, we compared the immunosuppressive regimens and infectious complications of pediatric kidney transplant recipients at a single institution who had previously undergone hematopoietic cell transplant from different donors to similar patients reported in the literature. Among the initial four post-hematopoietic cell transplant kidney transplant patients reviewed, viremia episodes were universal, including BK virus, Epstein-Barr virus, and human herpesvirus-6, with one death from presumed BK virus encephalitis...
April 27, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28449371/relationship-between-cytotoxic-t-lymphocyte-antigen-4-318c-t-rs5742909-gene-polymorphism-and-the-risk-of-acute-rejection-in-renal-transplantation
#6
Chun-Hua Yang, Xue-Xia Chen, Li Chen, Dong-Hua Zheng, Qiong-Shan Liu, Wen-Feng Xie, Tian-Biao Zhou, Gregor P C Drummen
Results on the relationship between CTLA4 -318C/T (rs5742909) gene polymorphism and risk of acute rejection in renal transplantation are still conflicting. This meta-analysis was performed to update the association between CTLA4 -318C/T and risk of acute rejection in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Twelve reports were included in this meta-analysis for the association of CTLA4 -318C/T gene polymorphism with acute rejection risk in renal transplantation, consisting of 728 acute rejection patients and 1628 non-acute rejection controls...
April 27, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28436075/does-a-meso-caval-shunt-have-positive-effects-in-a-pig-large-for-size-liver-transplantation-model
#7
Ana Cristina Aoun Tannuri, Daniel de Albuquerque Rangel Moreira, Alessandro Belon, Maria Cecília Mendonça Coelho, Josiane Oliveira Gonçalves, Suellen Serafini, Uenis Tannuri
In pediatric liver transplantations with LFS grafts, higher incidences of graft dysfunction probably occur due to IRI. It was postulated that increasing the blood supply to the graft by means of a meso-caval shunt could ameliorate the IRI. Eleven pigs underwent liver transplantation and were divided into two groups: LFS and LFS+SHUNT group. A series of flowmetric, metabolic, histologic, and molecular studies were performed. No significant metabolic differences were observed between the groups. One hour after reperfusion, portal flow was significantly lower in the recipients than in the donors, proving that the graft was maintained in low portal blood flow, although the shunt could promote a transient increase in the portal blood flow and a decrease in the arterial flow...
April 24, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28419703/exercise-capacity-following-pediatric-heart-transplantation-a-systematic-review
#8
Sara Peterson, Jennifer A Su, Jacqueline R Szmuszkovicz, Robert Johnson, Barbara Sargent
Pediatric HTs account for 13% of all HTs with >60% of recipients surviving at least 10 years post-HT. The purpose of this systematic review is to synthesize the literature on exercise capacity of pediatric HT recipients to improve understanding of the mechanisms that may explain the decreased exercise capacity. Six databases were searched for studies that compared the exercise capacity of HT recipients ≤21 years old with a control group or normative data. Sixteen studies were included. Pediatric HT recipients, as compared to controls or normative data, exhibit significantly higher resting HR, and at peak exercise exhibit significantly decreased HR, VO2 , power, work, minute ventilation, and exercise duration...
April 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28417522/determinants-of-large-drain-losses-early-after-pediatric-liver-transplantation
#9
Antonio Marseglia, Marco Ginammi, Michela Bosisio, Paola Stroppa, Michele Colledan, Lorenzo D'Antiga
The goal of this study was to evaluate postoperative ascites to correlate it with graft dysfunction and other complications. We therefore reviewed the files of patients transplanted between 2009 and 2014 to correlate drain losses with indication, patient and organ size, PELD, graft type, GRWR, NRBW, NGWD, cold ischemia time, histologically proven graft dysfunction, and surgical complications. Of 120 LTs in 104 patients, 48 (40%) were complicated by graft dysfunction, 43 (36%) by surgical complications, and 25 (21%) by cellular rejection...
April 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28419633/bk-virus-in-solid-organ-transplantation-pretransplant-screening-of-recipients-and-risk-factors-for-disease
#10
EDITORIAL
Arnaud G L'Huillier, Upton D Allen
No abstract text is available yet for this article.
April 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28397368/very-small-pediatric-donor-kidney-transplantation-in-pediatric-recipients
#11
H C Yaffe, P Friedmann, L K Kayler
Kidneys from very small pediatric donors (age <5 years, weight <21 kg) may be a means to increase the donor pool for pediatric recipients. Transplantation of small pediatric kidneys is more commonly performed in adult recipients due to the increased risks of technical complications, thrombosis, and early graft failure. While these risks are abrogated in adult recipients by limiting the donor weight to ≥10 kg and using the EB technique, it is unknown whether pediatric recipients achieve comparable results...
April 11, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28393434/multivisceral-transplantation-for-abdominal-tumors-in-children-a-single-center-experience-and-review-of-the-literature
#12
Eliza Lee, Nicole Hodgkinson, Rima Fawaz, Khashayar Vakili, Heung Bae Kim
Standard management of intra-abdominal pediatric solid tumors requires complete resection. However, tumors with multiple organ and vascular involvement present a unique surgical challenge. We conducted a retrospective chart review of four patients, aged 2-14 years, undergoing MVT for intra-abdominal tumors with significant involvement of the visceral arteries and/or portomesenteric venous system at our institution. Indications for MVT included hepatocellular carcinoma, inflammatory myofibroblastic tumor, and two cases of hepatoblastoma...
April 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28378408/cancer-recurrence-and-mortality-after-pediatric-heart-transplantation-for-anthracycline-cardiomyopathy-a-report-from-the-pediatric-heart-transplant-study-phts-group
#13
Matthew J Bock, Elfriede Pahl, Paolo G Rusconi, Gerard J Boyle, John J Parent, Clare J Twist, James K Kirklin, Elizabeth Pruitt, Daniel Bernstein
We aimed to determine whether malignancy after pediatric HTx for ACM affects overall post-HTx survival. Patients <18y listed for HTx for ACM in the PHTS database between 1993 and 2014 were compared to those with DCM. A 2:1 matched DCM cohort was also compared. Wait-list and post-HTx survival, along with freedom from common HTx complications, were compared. Eighty subjects were listed due to ACM, whereas 1985 were listed for DCM. Although wait-list survival was higher in the ACM group, post-HTx survival was lower for the ACM cohort...
April 4, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28485097/hematopoietic-stem-cell-transplantation-and-acute-kidney-injury-in-children-a-comprehensive-review
#14
REVIEW
Rupesh Raina, Nicholas Herrera, Vinod Krishnappa, Sidharth Kumar Sethi, Akash Deep, Wei-Ming Kao, Timothy Bunchman, Rolla Abu-Arja
AKI in the setting of HSCT is commonly investigated among adult patients. In the same way, malignancies requiring treatment with HSCT are not limited to the adult patient population, AKI following HSCT is frequently encountered within pediatric patient populations. However, inadequate information regarding epidemiology and pathophysiology specific to pediatric patients prevents development of appropriate and successful therapeutic strategies for those afflicted. Addressing AKI in the context of sinusoidal obstruction syndrome, chemotherapy, thrombotic microangiopathy and hypertension post chemotherapy, glomerulonephritis, and graft versus host disease provides greater insight into renal impairment associated with these HSCT-related ailments...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28464484/ambulatory-veno-venous-ecmo-in-adolescents-how-far-have-we-walked
#15
EDITORIAL
Christopher Towe, David L S Morales
No abstract text is available yet for this article.
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28455909/emergency-department-utilization-in-pediatric-heart-transplant-recipients
#16
Carol A Wittlieb-Weber, Joseph W Rossano, David R Weber, Kimberly Y Lin, Chitra Ravishankar, Christopher E Mascio, Robert E Shaddy, Matthew J O'Connor
We used the NEDS database (2010) to evaluate ED utilization in PED HT recipients compared to other patient populations with focus on characteristics of ED visits, risk factors for admission, and charges. We analyzed 433 ED visits by PED HT recipients (median age 8 [range: 0-18] years). The most common primary diagnosis category was infectious (n=163, 37.6%), with pneumonia being the most common infectious etiology. When compared to all PED visits, HT visits were more likely to result in hospital admission (32...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28425151/split-liver-grafts-can-benefit-both-pediatric-and-adult-liver-transplant-recipients-and-programs
#17
EDITORIAL
Leigh Anne Dageforde, William Chapman
No abstract text is available yet for this article.
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28425148/counting-the-publications-that-count
#18
EDITORIAL
Simon Horslen
No abstract text is available yet for this article.
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28371243/infection-rates-in-tacrolimus-versus-cyclosporine-treated-pediatric-kidney-transplant-recipients-on-a-rapid-discontinuation-of-prednisone-protocol-1-year-analysis
#19
Sarah J Kizilbash, Michelle N Rheault, Ananta Bangdiwala, Arthur Matas, Srinath Chinnakotla, Blanche M Chavers
AR is lower in pKTx recipients on Tac vs CsA. Data comparing infection outcomes for children treated with these agents are limited. We retrospectively studied infection outcomes in 96 pKTx recipients on a RDP. PS, DCGS, AR, and infection-free survival were assessed using Kaplan-Meier/log-rank tests and proportional hazards models. There were no differences in 1-year PS, DCGS, or AR between Tac and CsA recipients. After adjusting for AR, the hazard of CMV viremia was 4.0 times higher (95%CI: 1.04, 15.5; P = ...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28370952/dopamine-as-a-potential-rescue-therapy-for-refractory-protein-losing-enteropathy-in-fontan-palliated-patients
#20
Joshua M Friedland-Little, Robert J Gajarski, Kurt R Schumacher
PLE is an important cause of morbidity and mortality in patients who have undergone Fontan palliation. While multiple PLE therapies have been reported, none has proved consistently effective. Patients who do not respond to "standard" PLE therapies face poor long-term outcomes. We report here a significant response to dopamine infusion in three patients with chronic, refractory PLE. We hypothesize that this response may be at least partially due to a dopamine effect on lymphatic receptors rather than to an augmentation of cardiac output...
June 2017: Pediatric Transplantation
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