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Pediatric Transplantation

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https://www.readbyqxmd.com/read/29222873/calcineurin-inhibitor-associated-electrolyte-disturbances-after-pediatric-renal-transplantation-could-fludrocortisone-therapy-have-a-role
#1
EDITORIAL
Juuso Tainio
No abstract text is available yet for this article.
December 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29222866/outcome-of-antibody-mediated-rejection-compared-to-acute-cellular-rejection-after-pediatric-heart-transplantation
#2
Gabrielle R Vaughn, Neal W Jorgensen, Yuk M Law, Erin L Albers, Borah J Hong, Joshua M Friedland-Little, Mariska S Kemna
Outcomes of ACR after pediatric HTx have been well described, but less has been reported on outcomes of AMR. We compared the clinical characteristics and cardiovascular outcomes (composite end-point of death, retransplantation, or allograft vasculopathy) of pediatric HTx recipients with AMR, ACR, and no rejection in a retrospective single-center study of 104 recipients. Twenty were treated for AMR; 15 were treated for ACR. Recipients with AMR had an increased frequency of congenital heart disease (90% vs ACR 67% vs no rejection 59%, P = ...
December 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29218833/consideration-of-children-with-intellectual-disability-as-candidates-for-solid-organ-transplantation-a-practice-in-evolution
#3
Aaron Wightman, Douglas Diekema, Aviva Goldberg
Children with intellectual disability were historically excluded from consideration as recipients of solid organ transplants. In light of an evolution in provider practices, this commentary will define intellectual disability and review the relevant provider attitudes and guidelines and known outcomes of solid organ transplant in this population.
December 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29218832/necrotizing-enterocolitis-in-the-setting-of-milk-allergy-after-pediatric-living-donor-liver-transplantation
#4
Soichi Narumoto, Seisuke Sakamoto, Hajime Uchida, Kengo Sasaki, Takanobu Shigeta, Akinari Fukuda, Shunsuke Nosaka, Rie Irie, Takako Yoshioka, Mureo Kasahara
NEC is an idiopathic intestinal mucosal injury that may progress to transmural bowel necrosis without mesenteric ischemia. NEC usually affects 7- to 10-day-old neonates following enteral feeding. A 10-month-old girl with no history of laparotomy underwent LDLT for acute liver failure. After starting enteral feeding on postoperative day 5, she developed abdominal distention. Diffuse PVG and PI were detected by radiologic modalities. Exploratory laparotomy revealed patchy necrosis of the intestine without perforation...
December 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29218760/a-systematic-review-of-immunosuppressant-adherence-interventions-in-transplant-recipients-decoding-the-streetlight-effect
#5
REVIEW
S Duncan, R A Annunziato, C Dunphy, D LaPointe Rudow, B L Shneider, E Shemesh
Non-adherence to immunosuppressant medications is an important risk factor for graft dysfunction. To evaluate the effectiveness of adherence-enhancing interventions, we reviewed adherence intervention studies in solid organ transplant recipients (all ages). Using the following databases: PsycINFO, PubMed, Scopus, and ScienceDirect, we identified 41 eligible studies. Only three non-randomized trials showed a possible positive effect on objective indicators of transplant outcomes (such as rejection, liver enzyme levels, kidney function)...
December 7, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29210159/safety-of-mtor-inhibitor-continuation-in-pediatric-heart-transplant-recipients-undergoing-surgical-procedures
#6
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
December 6, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29197135/biventricular-support-with-heartware-ventricular-assist-device-in-a-pediatric-patient
#7
Shriprasad R Deshpande, Mallory M Carroll, Chad Mao, William T Mahle, Kirk Kanter
Use of ventricular assist devices is increasing in the pediatric population. This has included the extended use of adult continuous-flow devices in the pediatric population. In a minority of cases, biventricular support may be needed. In these situations, biventricular support with continuous-flow devices can be surgically challenging, and therefore, only few cases have been reported. Here, we present a case of implantation of two HeartWare HVAD devices for biventricular support for a decompensating patient with acute myocarditis as well as present an alternative implantation surgical strategy...
December 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29181879/high-human-herpesvirus-6-viral-load-in-pediatric-allogeneic-hematopoietic-stem-cell-transplant-patients-is-associated-with-detection-in-end-organs-and-high-mortality
#8
Lena E Winestone, Rajesh Punn, John S Tamaresis, Julia Buckingham, Benjamin A Pinsky, Jesse J Waggoner, Sandhya Kharbanda
Human Herpes Virus 6 (HHV-6) reactivation occurs in approximately half of patients following allogeneic hematopoietic stem cell transplant (HSCT). While encephalitis and delayed engraftment are well-documented complications of HHV-6 following HSCT, the extent to which HHV-6 viremia causes disease in children is controversial. We performed a retrospective review of HHV-6 reactivation and possible manifestations in pediatric allogeneic HSCT patients at a single institution. Of 89 children and young adults who underwent allogeneic HSCT over a three-and-a-half-year period, 34 patients reactivated HHV-6 early post-transplant...
November 27, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29171131/cpap-by-helmet-for-treatment-of-acute-respiratory-failure-after-pediatric-liver-transplantation
#9
F Chiusolo, V Fanelli, M L Ciofi Degli Atti, G Conti, F Tortora, R Pariante, L Ravà, C Grimaldi, J de Ville de Goyet, S Picardo
ARF after pediatric liver transplantation accounts for high rate of morbidity and mortality associated with this procedure. The role of CPAP in postoperative period is still unknown. The aim of the study was to describe current practice and risk factors associated with the application of helmet CPAP. In this retrospective observational cohort study, 119 recipients were divided into two groups based on indication to CPAP after extubation. Perioperative variables were studied, and determinants of CPAP application were analyzed in a multivariate logistic model...
November 24, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29160012/near-infrared-spectroscopy-might-be-a-useful-tool-for-predicting-the-risk-of-vascular-complications-after-pediatric-liver-transplants-two-case-reports
#10
Juntaro Shiba, Masaaki Satoh, Koki Taira, Yasunori Niwa, Soichiro Inoue, Koichi Mizuta, Mamoru Takeuchi
In patients that have undergone liver transplants, a postoperative reduction in the blood flow of the liver graft represents a critical complication. We recently encountered an interesting phenomenon; that is, we found that the rSO2 level of the liver graft, as measured by NIRS, drops in patients that subsequently require an emergency liver biopsy. An 8-month-old female and an 8-month-old male underwent living donor liver transplants for biliary atresia. In both cases, a reduction in rSO2 was detected before an emergency liver biopsy was required...
November 21, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29144053/the-impact-of-flow-pra-on-outcome-in-pediatric-heart-recipients-in-modern-era-an-analysis-of-the-pediatric-heart-transplant-study-database
#11
B B Das, E Pruitt, K Molina, W Ravekes, S Auerbach, A Savage, L Knox, J K Kirklin, D C Naftel, D Hsu
Data from patients in the Pediatric Heart Transplant Study (PHTS) registry transplanted between 2010 and 2014 were analyzed to determine the association between HLA antibody (PRA) determined by SPA using Luminex or flow cytometry with a positive retrospective cross-match and the post-transplant outcomes of acute rejection and graft survival. A total of 1459 of 1596 (91%) recipients had a PRA reported pretransplant; 26% had a PRA > 20%. Patients with a PRA > 20% were more likely to have CHD, prior cardiac surgery, ECMO support at listing, and waited longer for transplantation than patients with a PRA <20%...
November 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29139617/world-s-smallest-combined-en-bloc-liver-pancreas-transplantation
#12
Ahmed M Elsabbagh, Jason Hawksworth, Khalid M Khan, Nada Yazigi, Cal S Matsumoto, Thomas M Fishbein
We present a case of a 2-year-old child who underwent a combined en bloc liver and pancreas transplant following complications of WRS. WRS is characterized clinically through infantile insulin-dependent diabetes mellitus, neutropenia, recurrent infections, propensity for liver failure following viral infections, bone dysplasia, and developmental delay. Usually, death occurs from fulminant liver and concomitant kidney failure. Few cases with WRS are reported in the literature, mostly from consanguineous parents...
November 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29139589/severe-fasting-hypoglycemia-in-a-child-after-total-pancreatectomy-with-islet-autotransplantation
#13
Jacob M Redel, Jaimie D Nathan, Maisam Abu-El-Haija, Tom K Lin, Joseph J Palermo, Deborah A Elder
TPIAT is an increasingly utilized treatment option for select children with CP. Post-TPIAT fasting hypoglycemia, unrelated to exogenous insulin, is a complication recently reported in adults. This phenomenon has not been described in children. We review a case of severe fasting hypoglycemia in an adolescent female occurring 10 months post-TPIAT. A 12-year-old girl underwent TPIAT for CP. Ten months postoperatively she developed recurrent hypoglycemia on a total daily insulin dose of 0.03 units/kg. Consequently, insulin therapy was discontinued...
November 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29131462/outcomes-of-liver-transplantation-in-pediatric-recipients-with-cardiovascular-disease
#14
Márcio Miranda Brito, Joao Seda Neto, Eduardo A Fonseca, Renata Pugliese, Vera B Danesi, Helry L Candido, Adriana Porta, Cristian V B Borges, Gilda Porta, Paulo Chapchap, Irene Kazue Miura
LT exerts considerable stress on the heart perioperatively. Limited data exist on impact of cardiovascular diseases on LT children. This study evaluated the outcomes of children with CVD who underwent LT and compared with pretransplant findings. From 518 LT recipients, 82 (15.8%) had CVD. Sixty patients were classified as low-risk adjustment for congenital heart surgery 1 (RACHS 1 and 2). Five patients were classified as RACHS ≥3. The most common echocardiographic finding in the CVD patients (25/82) was ASD...
November 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29105236/liver-abnormalities-and-post-transplant-survival-in-pediatric-fontan-patients
#15
Sophie C Hofferberth, Tajinder P Singh, Heather Bastardi, Elizabeth D Blume, Francis Fynn-Thompson
The impact of liver parenchymal abnormalities on survival post-heart transplant remains unknown in pediatric Fontan patients. We assessed pediatric Fontan patients who underwent heart transplant and had documented pretransplant hepatic ultrasound (U/S) studies. Liver U/S findings were classified as normal (Group 1), mildly abnormal (Group 2, hepatomegaly/vascular congestion), or severely abnormal (Group 3, heterogeneous echotexture/nodularity). Among 30 study patients, 8 were classified as Group 1, 14 as Group 2, while 8 met Group 3 criteria...
November 3, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29094445/kidney-transplantation-in-a-child-with-pierson-syndrome
#16
Sanem Guler, Sertac Cimen, Phillip Acott, Kathy Whelan, Michele Molinari
Congenital nephrotic syndrome is commonly associated with mutations in genes that encode podocyte and slit diaphragm proteins or the structural and regulatory proteins of the GBM. These mutations lead to the formation of dysfunctional proteins, which account for the resistance of the renal manifestations to conventional treatment methods. Consequently, patients become renal replacement therapy dependent. Mutation of the LAMB2 gene is associated with Pierson syndrome, which is an autosomal recessive disorder characterized by congenital nephrotic syndrome and ocular abnormalities...
November 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29090853/preexisting-anti-hla-donor-specific-antibodies-in-pediatric-renal-transplant-recipients-a-new-challenge
#17
EDITORIAL
Lutz T Weber
No abstract text is available yet for this article.
November 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29082673/early-bacterial-and-fungal-infection-in-children-receiving-allogeneic-stem-cell-transplantation-for-acute-lymphoblastic-leukemia-in-argentina
#18
S Gomez, A B Fynn, S Fernanda, V Cecilia, L Sung
Infections are important complications associated with allogeneic HSCT. Describing infection rates in low- and middle-income countries provides data to infer efficacy of supportive care practices in these settings. In this retrospective cohort study, we included patients (age ≤ 18 years) who underwent a first allogeneic HSCT for ALL in a single center in Argentina between 1998 and 2016. The primary outcome was sterile site bacterial infection. Secondary outcomes were proven or probable invasive fungal infection, TRM, and infectious deaths...
October 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29082660/anellovirus-loads-are-associated-with-outcomes-in-pediatric-lung-transplantation
#19
Joshua A Blatter, Stuart C Sweet, Carol Conrad, Lara A Danziger-Isakov, Albert Faro, Samuel B Goldfarb, Don Hayes, Ernestina Melicoff, Marc Schecter, Gregory Storch, Gary A Visner, Nikki M Williams, David Wang
Anelloviruses are DNA viruses ubiquitously present in human blood. Due to their elevated levels in immunosuppressed patients, anellovirus levels have been proposed as a marker of immune status. We hypothesized that low anellovirus levels, reflecting relative immunocompetence, would be associated with adverse outcomes in pediatric lung transplantation. We assayed blood samples from 57 patients in a multicenter study for alpha- and betatorquevirus, two anellovirus genera. The primary short-term outcome of interest was acute rejection, and longer-term outcomes were analyzed individually and as "composite" (death, chronic rejection, or retransplant within 2 years)...
October 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29082641/risk-factors-for-urological-complications-following-living-donor-renal-transplantation-in-children
#20
Mohammed S ElSheemy, Waleed Ghoneima, Waseem Aboulela, Kareem Daw, Ahmed M Shouman, Ahmed I Shoukry, Sherif Soaida, Doaa M Salah, Hafez Bazaraa, Fatina I Fadel, Ahmed A Hussein, Enmar Habib, Ismail R Saad, Mohamed El Ghoneimy, Hany A Morsi, Mohammed A Lotfi, Hesham Badawy
The aim of this study was to detect possible risk factors for UC and UTI following pediatric renal Tx and effect of these complications on outcome. One hundred and eight children who underwent living donor Tx between 2009 and 2015 were retrospectively included. Extraperitoneal approach was used with stented tunneled extravesical procedure. Mean recipient age was 9.89 ± 3.46 years while mean weight was 25.22 ± 10.43 kg. Seventy-three (67.6%) recipients were boys while 92 (85.2%) were related to donors...
October 29, 2017: Pediatric Transplantation
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