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Pediatric Transplantation

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https://www.readbyqxmd.com/read/28436075/does-a-meso-caval-shunt-have-positive-effects-in-a-pig-large-for-size-liver-transplantation-model
#1
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/28425151/split-liver-grafts-can-benefit-both-pediatric-and-adult-liver-transplant-recipients-and-programs
#2
EDITORIAL
Leigh Anne Dageforde, William Chapman
No abstract text is available yet for this article.
April 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28425148/counting-the-publications-that-count
#3
EDITORIAL
Simon Horslen
No abstract text is available yet for this article.
April 19, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28419703/exercise-capacity-following-pediatric-heart-transplantation-a-systematic-review
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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/28371243/infection-rates-in-tacrolimus-versus-cyclosporine-treated-pediatric-kidney-transplant-recipients-on-a-rapid-discontinuation-of-prednisone-protocol-1-year-analysis
#10
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 = ...
March 31, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28370903/impact-of-post-transplant-minimal-residual-disease-on-the-clinical-outcome-of-pediatric-acute-leukemia
#11
Katsutsugu Umeda, Atsushi Iwai, Koji Kawaguchi, Masamitsu Mikami, Seishiro Nodomi, Satoshi Saida, Hidefumi Hiramatsu, Toshio Heike, Katsuyuki Ohmori, Souichi Adachi
This retrospective study examined the clinical significance of FCM-MRD in 36 patients with ALL and 29 patients with AML after their first allogeneic HSCT. Hematological (FCM-MRD ≥5.0%) and molecular relapse (FCM-MRD <5.0%) were first detected in 10 and two patients with ALL and in seven and eight patients with AML, respectively. Eight of 10 patients with molecular relapse eventually progressed to hematological relapse, although most were treated with immunological intervention by aggressive discontinuation of immunosuppressive therapy or donor lymphocyte infusion...
March 31, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28370952/dopamine-as-a-potential-rescue-therapy-for-refractory-protein-losing-enteropathy-in-fontan-palliated-patients
#12
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...
March 30, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28333403/association-of-cytotoxic-t-lymphocyte-antigen-4-49a-g-gene-polymorphism-with-acute-rejection-risk-in-renal-transplantation
#13
Chun-Hua Yang, Xue-Xia Chen, Li Chen, Dong-Hua Zheng, Qiong-Shan Liu, Wen-Feng Xie
The conclusions on the association between cytotoxic T-lymphocyte antigen 4 (CTLA4) +49A/G gene polymorphism and acute rejection risk in renal transplantation are still debated. This meta-analysis was performed to update the association between CTLA4 +49A/G and acute rejection risk in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Fourteen reports were included into this meta-analysis for the association of CTLA4 A/G gene polymorphism and acute rejection risk in renal transplantation, consisting of 962 acute rejection patients and 2084 non-acute rejection controls...
March 23, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28332273/reducing-the-incidence-of-hepatic-artery-thrombosis-in-pediatric-liver-transplantation-effect-of-microvascular-techniques-and-a-customized-anticoagulation-protocol
#14
William A Ziaziaris, Alexandre Darani, Andrew J A Holland, Angus Alexander, Jonathan Karpelowsky, Pasquale Barbaro, Michael Stormon, Edward O'Loughlin, Albert Shun, Gordon Thomas
We aimed to assess the incidence of HAT over three eras following implementation of microvascular techniques and a customized anticoagulation protocol in a predominantly cadaveric split liver transplant program. We retrospectively reviewed pediatric liver transplants performed between April 1986 and 2016 and analyzed the incidence HAT over three eras. In E1, 1986-2008, each patient received a standard dose of 5 U/kg/h of heparin and coagulation profiles normalized passively. In E2, 2008-2012, microvascular techniques were introduced...
March 22, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28332262/haploidentical-peripheral-blood-stem-cell-transplantation-without-irradiation-or-busulfan-after-reduced-intensity-conditioning-for-kmt2a-mll-rearranged-infant-b-cell-precursor-acute-lymphoblastic-leukemia-report-of-two-cases
#15
Ai Yoshimi, Keisuke Kato, Sho Hosaka, Ryoko Suzuki, Hiroko Fukushima, Tomohei Nakao, Chie Kobayashi, Takashi Fukushima, Kazutoshi Koike, Ryo Sumazaki, Masahiro Tsuchida
We present two infants with KMT2A(MLL)-gene-R-associated BCP-ALL, who received HLA haploidentical PBSCT after RIC. The patients developed ALL at age 6 months and 3 months, respectively. Case 1 underwent PBSCT at the second CR with detectable KMT2A-AFF1(MLL-AF4) fusion gene transcript at 11 months of age, and Case 2 at the first CR without KMT2A-MLLT1(MLL-ENL) fusion gene transcript at 8 months of age. Both patients received G-CSF-mobilized unmanipulated peripheral blood mononuclear cells from their HLA haploidentical mothers after administration of FLU, MEL, and ATG...
March 22, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28328064/a-bibliometric-analysis-of-pediatric-liver-transplantation-publications
#16
Dermot T McDowell, Alexandre Darani, Albert Shun, Gordon Thomas, Andrew J A Holland
Citation counts can identify landmark papers. The aim of this study was to identify and characterize the top-cited articles in the pediatric liver transplantation literature. A search strategy for the Scopus(®) database was designed for pediatric liver transplantation publications from 1945 to 2014. The 50 top-cited articles were analyzed. Author co-citation analysis was performed using VOSviewer techniques. There were 2896 articles published between 1969 and 2015. The mean citation count of the top 50 cited articles was 166 (range 95-635)...
March 22, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28322484/tfe3-positive-renal-cell-carcinoma-occurring-in-three-children-with-dysfunctional-kidneys-on-immunosuppression
#17
Beverly A Schaefer, Theodore S Johnson, David K Hooper, Jaimie D Nathan, James I Geller
Pediatric RCC is a rare pediatric neoplasm and is distinctly different compared to adult RCC, often demonstrating translocation morphology evidenced by unique histopathological features and TFE3 or TFEB nuclear expression. We report three cases of pediatric TFE3 positive RCC (TFE3-RCC) occurring in the setting of chronic kidney disease and long-term pharmacological immunosuppression, including two cases that developed in the native kidney following kidney transplantation. Together, these cases suggest that the kidney microenvironment in combination with immune dysregulation is likely contributing factors in the pathogenesis of some pediatric RCC, warranting further study...
March 21, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28295949/portosystemic-shunt-as-a-bridge-to-liver-transplantation-in-infants-a-comparison-of-two-techniques
#18
Dor Yoeli, N Thao N Galván, Daniel J Ashton, Kayla R Kumm, Michael L Kueht, Ellen D Witte, Tamir A Miloh, Ronald T Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
Portosystemic shunts can serve as a bridge to liver transplantation in patients with end-stage liver disease by providing portal decompression to treat life-threatening variceal bleeding and prevent recurrent episodes until an organ becomes available. The conventional TIPS procedure, however, is technically challenging to perform in infants due to the small size of their intrahepatic vasculature. We report two cases of emergent creation of portosystemic shunts as a bridge to liver transplantation in infants with life-threatening variceal bleeding using a conventional TIPS technique in the first case and a percutaneous DIPS technique in the other...
March 13, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28295952/long-term-outcomes-of-living-related-small-intestinal-transplantation-in-children-a-single-center-experience
#19
Sandra Garcia Aroz, Ivo Tzvetanov, Elizabeth Anne Hetterman, Hoonbae Jeon, Jose Oberholzer, Giuliano Testa, Eunice John, Enrico Benedetti
Pediatric patients with irreversible intestinal failure present a significant challenge to meet the nutritional needs that promote growth. From 2002 to 2013, 13 living-related small intestinal transplantations were performed in 10 children, with a median age of 18 months. Grafts included isolated living-related intestinal transplantation (n=7), and living-related liver and small intestine (n=6). The immunosuppression protocol consisted of induction with thymoglobulin and maintenance therapy with tacrolimus and steroids...
March 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28295914/development-of-a-gastric-carcinoid-tumor-following-allogeneic-hematopoietic-stem-cell-transplantation-for-early-t-cell-precursor-acute-lymphoblastic-leukemia
#20
Tsung-Yen Chang, Jin-Yao Lai, Chao-Jan Wang, Shih-Yen Chen, Tang-Her Jaing, Chuen Hsueh, Lee-Yung Shih, Shih-Hsiang Chen
Gastric carcinoid tumor is rarely diagnosed in children. We report a case of gastric carcinoid tumor that occurred after allogeneic HSCT. A 13-year-old girl with ETP acute lymphoblastic leukemia underwent allogeneic HSCT from a 7/8 HLA-matched unrelated donor. She presented with rashes, abdominal pain, and diarrhea, which were suggestive of GVHD, 7 months after HSCT. Immunosuppressive agents failed to resolve these symptoms well. After a series of evaluations, carcinoid syndrome caused by a gastric carcinoid tumor was diagnosed...
March 11, 2017: Pediatric Transplantation
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