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Pediatric Transplantation

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https://www.readbyqxmd.com/read/27900821/the-predictive-value-of-resistive-index-obtained-by-doppler-ultrasonography-early-after-renal-transplantation-on-long-term-allograft-function
#1
Engin Melek, Esra Baskın, Kaan Gulleroglu, Nihal Uslu, Mahir Kırnap, Gokhan Moray, Mehmet Haberal
DUSG is a useful diagnostic tool for the follow-up of renal transplant recipients. The measurement of intrarenal arterial RI by DUSG has been proven to predict short-term AF. The aim of the study was to evaluate the predictive value of DUSG performed during the early after RTx on long-term AF. Seventy patients were enrolled into study. DUSG was performed at third and seventh days after RTx. Patients were divided into two groups according to rate of recovery of graft function as patients with normal graft function and abnormal graft function...
November 29, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27891735/hyperammonemia-in-ornithine-transcarbamylase-deficient-recipients-following-living-donor-liver-transplantation-from-heterozygous-carrier-donors
#2
Tri Hening Rahayatri, Hajime Uchida, Kengo Sasaki, Takanobu Shigeta, Yoshihiro Hirata, Hiroyuki Kanazawa, Vidyadhar Mali, Akinari Fukuda, Seisuke Sakamoto, Mureo Kasahara
Ornithine transcarbamylase deficiency (OTCD) is a urea cycle disorder of X-linked inheritance, affecting the detoxification of excess nitrogen and leading to hyperammonemia (hyper-NH3 ). Living donor liver transplantation (LDLT) has been applied for the treatment of OTCD. This case series retrospectively reviewed two OTCD patients who experienced hyper-NH3 following LDLT. The first case was a 5-year-old girl who had onset of OTCD at 2 years of age. Ornithine transcarbamylase (OTC) enzyme activity was 62% for the donor and 15% for the recipient...
November 28, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27891727/rehospitalization-after-pediatric-heart-transplantation-incidence-indications-and-outcomes
#3
Seth A Hollander, Doff B McElhinney, Christopher S Almond, Nancy McDonald, Sharon Chen, Beth D Kaufman, Daniel Bernstein, David N Rosenthal
We report the patterns of rehospitalization after pediatric heart transplant (Htx) at a single center. Retrospective review of 107 consecutive pediatric Htx recipients between January 22, 2007, and August 28, 2014, who survived their initial transplant hospitalization. The frequency, duration, and indications for all hospitalizations between transplant hospitalization discharge and September 30, 2015, were analyzed. A total of 444 hospitalization episodes occurred in 90 of 107 (84%) patients. The median time to first rehospitalization was 59...
November 27, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27885788/barriers-to-live-donor-kidney-transplants-in-the-pediatric-population-a-single-center-experience
#4
Shibany P Taormina, Matthew P Galloway, Amrish Jain
A decrease in live donor pediatric kidney transplants has occurred in the United States. This study investigates barriers that may influence access to live donor kidney transplants in children. Retrospective chart review was conducted for 91 children (69% male, mean age 11.9 years) who underwent pretransplant workup from 2005 to 2015 at an urban pediatric hospital. Fifty-four percent were African American, 32% Caucasian, 8% Arabic, 3% Hispanic, and 3% Others. Government-sponsored insurance (Medicaid/Medicare) was utilized by 73%, and 54% had dual caregivers...
November 25, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27885760/haploidentical-hematopoietic-stem-cell-transplantation-for-a-case-with-x-linked-chronic-granulomatous-disease
#5
Ling Zhou, Lu-Jia Dong, Zhi-Yong Gao, Xin-Jian Yu, Dao-Pei Lu
CGD is a rare primary immunodeficiency with high mortality rates when treated conventionally, especially for the X-chromosome-linked form. HSCT is the only curative therapy for CGD; however, haploidentical transplantation in CGD is rare. Here, we report a case of X-linked CGD treated successfully by haploidentical HSCT. The patient showed a positive result with full donor chimerism, good quality of life, and the absence of recurrent infectious diseases at follow-up (68 months). Thus, haploidentical HSCT may serve as an acceptable treatment approach for patients who have CGD, but no HLA-matched related or unrelated donor...
November 25, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27882637/transplantation-associated-thrombotic-microangiopathy-isolated-to-a-congenital-anomaly-of-the-lung
#6
Rebecca T Kummen, Geoffrey D E Cuvelier, Camelia Stefanovici, Anamarija M Perry, Rick Higgins, Rochelle Yanofsky, Suyin A Lum Min, Donna A Wall
TA-TMA is a post-hematopoietic stem cell transplant complication with clinical features of hemolytic anemia and thrombocytopenia. A 26-month-old child who had had an allogeneic transplant for treatment of DBA developed severe TA-TMA with heavy red blood cell and platelet transfusion dependence. Incidentally, he was found to have a lung sequestration. TA-TMA resolved and transfusion dependence resolved after resection of the sequestration. The finding suggests the malformation vasculature was selectively vulnerable to the trigger of TA-TMA-raising perhaps a clue to basic pathophysiology of TA-TMA and/or vascular malformations...
November 24, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27862714/de-novo-inflammatory-bowel-disease-after-pediatric-kidney-or-liver-transplant
#7
Melissa A Fernandes, Hillary J Braun, Kim Evason, Sue Rhee, Emily R Perito
A subset of children who receive a liver and/or kidney transplant develop de novo inflammatory bowel disease-like chronic intestinal inflammation, not explained by infection or medications, following transplant. We have conducted a single-center, retrospective case series describing the unique clinical and histologic features of this IBD-like chronic intestinal inflammation following solid organ transplant. At our center, nine of 327 kidney or liver recipients developed de novo IBD following transplant (six liver, two kidney, one liver-kidney)...
November 11, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27862703/alemtuzumab-campath-1h-therapy-for-refractory-rejections-in-pediatric-heart-transplant-recipients
#8
Bibhuti Das, Vivian Dimas, Kristine Guleserian, Chantale Lacelle, Kristin Anton, Lindy Moore, Robert Morrow
Despite substantial improvements in survival after pediatric heart transplantation, refractory rejection remains a major cause of morbidity and mortality. We have utilized ALE (Campath-1H) in six consecutive patients with refractory rejection. These rejection episodes persisted despite conventional treatment, which included intravenous methylprednisolone, rituximab, immunoglobulin G, and antithymocyte globulin. In our series, after ALE therapy, LV SF increased from 22%±5% to 33%±5% (P=.01). However, in our series, ALE therapy neither led to persistent LV function recovery nor could it prevent subsequent antibody-mediated rejection...
November 11, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27813281/factors-associated-with-bone-marrow-stem-cell-yield-for-pediatric-allogeneic-stem-cell-transplantation-the-impact-of-donor-characteristics
#9
Ali Fettah, Namık Özbek, Meltem Özgüner, Fatih Azık, Pamir Işık, Zekai Avcı, Neşe Yaralı, Duygu Uçkan, Bahattin Tunç
The aim of this study was to investigate the effects of donor characteristics on CD34(+) cell yield in BM harvest. Between April 2010 and November 2013, consecutive donors who underwent BM harvesting in our BM transplantation unit were retrospectively investigated. Donors were classified into two groups: those who donated BM without mobilization (steady-state BM donors) and those who received G-CSF for stem cell mobilization (G-CSF-primed BM donors). Donor characteristics (age, gender, race, body weight, BMI, and laboratory factors including donor's leukocyte, platelet, and monocyte) and their relationship with total nuclear cell and CD34(+) cell numbers has been evaluated...
November 4, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27804197/skin-cancer-risk-education-in-pediatric-solid-organ-transplant-patients-an-evaluation-of-knowledge-behavior-and-perceptions-over-time
#10
Carrie C Coughlin, Maria Pérez, Monique G Kumar, Donna B Jeffe, Susan J Bayliss, Kara Sternhell-Blackwell
Skin cancer risk is elevated in solid OTRs. Studies of skin cancer awareness and sun-protection behaviors in pOTRs have not been reported. We measured effects over time of a multimodal educational intervention on knowledge of sun-protection practices and skin cancer risk, engagement in sun-protection behaviors, and self-efficacy and perceived barriers to photoprotection in pOTRs, their guardians, and a comparison group of children and guardians. Knowledge about skin cancer risk increased in pOTRs and their guardians (P≤...
November 1, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27804189/distance-is-associated-with-mortality-on-the-waitlist-in-pediatric-liver-transplantation
#11
Joel T Adler, Yanik J Bababekov, James F Markmann, David C Chang, Heidi Yeh
The distance to liver transplant centers affects outcomes in adult liver transplantation. Because pediatric patients are particularly vulnerable, we hypothesized that distance adversely affects the time to transplantation and waitlist mortality. The SRTR was queried for isolated pediatric liver transplant registrants (under age 18) with valid ZIP code information from 2003 to 2012. Distance was measured from home ZIP code to listing transplant center. Competing events analysis, adjusted for demographic factors, indication, and PELD, was undertaken for transplantation and death while on the waitlist...
November 1, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27804185/early-post-transplant-hyperbilirubinemia-is-a-possible-predictive-factor-for-developing-neurological-complications-in-pediatric-living-donor-liver-transplant-patients-receiving-tacrolimus
#12
Kazushige Sato, Yoshinobu Kobayashi, Atsushi Nakamura, Daizo Fukushima, Susumu Satomi
The cause of post-transplant CNI-NCs is multifactorial and not ascribed solely to CNI toxicity. A total of 90 children (aged <20 years) who underwent LDLT were evaluated to investigate the predictive factors associated with CNI-NCs. Twelve patients (13.3%) developed CNI-NCs after LDLT (age range, 2-15 years). The symptoms of CNI-NCs were seizures, VD, and stupor. The median onset of CNI-NCs was 10 days (range, 5-30 days) post-transplant. In the univariate analysis, higher recipient age at LDLT, donor age and recipient's BW, lower actual GV/SLV and TAC dosage/BW, and higher mean T-Bil and sodium level for 7 days after transplantation were independently significantly associated with TAC-NCs...
November 1, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27801533/prevalence-and-outcomes-of-heart-transplantation-in-children-with-intellectual-disability
#13
Aaron Wightman, Heather L Bartlett, Qianqian Zhao, Jodi M Smith
Heart transplantation in children with intellectual disability is a controversial issue. We sought to describe the prevalence and outcomes of heart transplantation in children with intellectual disability and hypothesized that recipients with intellectual disability have comparable short-term outcomes compared to recipients without intellectual disability. We performed a retrospective cohort analysis of children receiving a first heart-alone transplant in the UNOS STAR database from 2008 to 2013. Recipients with intellectual disability were compared to those without using chi-square tests...
November 1, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27796068/percutaneous-interventional-management-of-biliary-complications-after-pediatric-liver-transplantation-a-16-year-single-institution-experience
#14
Hasmukh J Prajapati, Pavan Kavali, Hyun S Kim
The aim of the study was to investigate the BiCx after the pediatric OLT and to assess the efficacy of the fluoroscopic-guided PBI in the patients with BiCx as compared to the SR. A total of 340 OLTs were performed in 302 patients over the last 16 years. The inclusion criteria were the presence of BS or BL as a complication after OLT. The management of the BiCx was studied. Graft revision, graft loss, and survival were evaluated following PBI and SR. BiCx occurred in 17.1% (58/339) of the transplants; 6.2% (21/339) of transplants demonstrated BL and 12...
October 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27796066/decline-in-ventricular-function-as-a-result-of-general-anesthesia-in-pediatric-heart-transplant-recipients
#15
Justin J Elhoff, Shahryar M Chowdhury, Carolyn L Taylor, Marc Hassid, Andrew J Savage, Andrew M Atz, Ryan J Butts
Echocardiography is frequently performed under anesthesia during procedures such as cardiac catheterization with EMB in pediatric HTx recipients. Anesthetic agents may depress ventricular function, resulting in concern for rejection. The aim of this study was to compare ventricular function as measured by echocardiography before and during GA in 17 pediatric HTx recipients. Nearly all markers of ventricular systolic function were significantly decreased under GA, including EF (-4.2% ±1.2, P < .01) and RV FAC (-0...
October 30, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27781378/mass-cytometry-reveals-a-distinct-immunoprofile-of-operational-tolerance-in-pediatric-liver-transplantation
#16
Audrey H Lau, Matthew J Vitalone, Kelly Haas, Todd Shawler, Carlos O Esquivel, William E Berquist, Olivia M Martinez, Ricardo O Castillo, Sheri M Krams
Long-term IS in transplant patients has significant morbidity, poorer quality of life, and substantial economic costs. TOL, defined as graft acceptance without functional impairment in the absence of IS, has been achieved in some pediatric LT recipients. Using mass cytometry, peripheral blood immunotyping was performed to characterize differences between tolerant patients and patients who are stable on single-agent IS. Single-cell mass cytometry was performed using blood samples from a single-center pediatric LT population of operationally tolerant patients to comprehensively characterize the immune cell populations in the tolerant state compared with patients on chronic low-dose IS...
October 26, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27781344/endoscopic-antireflux-surgery-leading-to-obstruction-in-pediatric-renal-transplant-patients
#17
Gina Cambareri, Christina Carpenter, Jeffrey Stock, Jane Lewis, Sarah Marietti
To describe a multicenter experience with management of ureteral obstruction after injection of Dx/HA for VUR in pediatric renal transplant patients. The records of all pediatric renal transplant patients who underwent Dx/HA injection for VUR and had subsequent obstruction were identified, and the management and outcomes were reviewed. Follow-up ranged from 1 to 10 years. There were four patients identified, all of whom had a history of rising creatinine, recurrent UTI, and increasing hydronephrosis which led to the diagnosis of high-grade VUR...
October 26, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27774712/the-histological-quantification-of-alpha-smooth-muscle-actin-predicts-future-graft-fibrosis-in-pediatric-liver-transplant-recipients
#18
Sharat Varma, Xavier Stéphenne, Mina Komuta, Caroline Bouzin, Jerome Ambroise, Françoise Smets, Raymond Reding, Etienne M Sokal
Activated hepatic stellate cells express cytoplasmic ASMA prior to secreting collagen and consequent liver fibrosis. We hypothesized that quantifying ASMA could predict severity of future fibrosis after LT. For this, 32 pairs of protocol biopsies, that is, "baseline" and "follow-up" biopsies taken at 1- to 2-year intervals from 18 stable pediatric LT recipients, transplanted between 2006 and 2012 were selected. Morphometric quantification of "ASMA-positive area percentage" was performed on the baseline biopsy...
October 23, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27774707/bocavirus-infection-following-paediatric-liver-transplantation
#19
M Y Tan, L N Tan, M M Aw, S H Quak, S V Karthik
HBoV is an emergent virus, which is frequently detected as a co-infective agent. However, it can cause disease on its own. It is associated with respiratory and diarrhoeal illness in children and adults, whether immunocompetent or immunocompromised. We report HBoV infection in a child post-liver transplantation, who presented with persistent fever and mild tachypnea, 3 weeks after a successful transplant. She recovered spontaneously with no graft dysfunction.
October 23, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27770486/nutritional-status-and-weakness-following-pediatric-hematopoietic-cell-transplantation
#20
Sandra Bouma, Mark Peterson, Erin Gatza, Sung Won Choi
Survivorship after pediatric HCT has increased over the past decade. Focus on long-term care and well-being remains critical due to risk of poor dietary habits and exaggerated sedentary behavior, which can lead to muscle weakness, increased risk for obesity, and cardiometabolic disorders. Nutrition and physical activity are key factors in survivorship; however, data are limited. Comprehensive nutritional assessments, including nutrition-focused physical examination, grip strength, and food/activity surveys, were completed in 36 pediatric HCT survivors (aged 2-25 years)...
October 21, 2016: Pediatric Transplantation
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