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Liver transplantation pediatric

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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
#1
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/29443826/higher-risk-of-posttransplant-graft-failure-in-male-recipients-of-female-donor-grafts-might-not-be-due-to-anastomotic-size-disparity
#2
Kyo Won Lee, Sangbin Han, Sanghoon Lee, Hyun-Hwa Cha, Soohyun Ahn, Hyeon Seon Ahn, Justin S Ko, Mi Sook Gwak, Gaab Soo Kim, Jae-Won Joh, Suk-Koo Lee, Gyu-Seong Choi
BACKGROUND: Posttransplant liver graft failure occurs most often in male recipients of livers from female donors. The respective role of donor sex itself and the size disparity in graft vessels/bile ducts according to donor sex are unclear. Thus, we aimed to evaluate the importance of donor sex with adjustment for anastomotic size disparity between female and male donor grafts. METHODS: A total of 309 male patients without hepatic tumors who underwent living donor liver transplantation were analyzed (109 female and 200 male donors)...
February 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29441651/invasive-pneumococcal-infections-in-pediatric-liver-small-bowel-pancreas-transplant-recipients
#3
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/29435902/pediatric-living-donor-liver-transplantation-using-a-monosegment-procured-by-pure-3d-laparoscopic-left-lateral-sectionectomy-and-in-situ-reduction
#4
Suk Kyun Hong, Kyung-Suk Suh, Hyo-Sin Kim, Kyung Chul Yoon, Sung-Woo Ahn, Hyeyoung Kim, Nam-Joon Yi, Kwang-Woong Lee
BACKGROUND: Improvements in laparoscopic imaging systems and instruments have increased the performance of pure laparoscopic living donor hepatectomy. This operation is no longer limited to left lateral sectionectomy but is used for left hepatectomy and right hepatectomy.1-5 This report describes a donor who underwent pure laparoscopic left lateral sectionectomy and in situ reduction using 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography to obtain a monosegment...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29424263/intraoperative-transesophageal-echocardiogram-during-orthotopic-liver-transplantation-tee-to-the-rescue
#5
Lorenzo De Marchi, Janice Lee, Nina Rawtani, Vinh Nguyen
Supported by a growing number of studies and case reports in the literature, perioperative use of TEE in non-cardiac cases has significantly increased the past two decades. The utility of TEE in monitoring hemodynamic, and diagnosing causes of hypotension refractory to conventional therapy, have made it an almost indispensible tool during major surgeries, such liver transplantation. Despite this fact, compared to the adult population, there is a lack of an equivalent amount of literature on the perioperative use of TEE in pediatric cases...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29423936/population-pharmacokinetics-of-enoxaparin-in-early-stage-of-pediatric-liver-transplantation
#6
Mehdi Oualha, Christophe Chardot, Dominique Debray, Fabrice Lesage, Annie Harroche, Sylvain Renolleau, Jean-Marc Treluyer, Saïk Urien
AIM: Preventing post liver transplantation (LT) hepatic artery and portal vein thrombosis includes enoxaparin administration. Enoxaparin pharmacokinetics (PK) has not been investigated in children following LT. We described an enoxaparin PK model in 22 children the first week following the LT. METHODS: Anti-Xa activity time-courses were analyzed using a nonlinear mixed effects approach with Monolix version 2016R. RESULTS: Anti-Xa activity time-courses were well described by a one-compartment model with first order absorption and elimination...
February 8, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29417691/incidence-risk-factors-and-outcomes-related-with-neurological-events-after-liver-transplantation-in-adult-and-pediatric-recipients
#7
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/29410290/one-thousand-pediatric-liver-transplants-during-thirty-years-lessons-learned
#8
Robert S Venick, Douglas G Farmer, Jose R Soto, Jorge Vargas, Hasan Yersiz, Fady M Kaldas, Vatche G Agopian, Jonathan R Hiatt, Sue V McDiarmid, Ronald W Busuttil
BACKGROUND: Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experiences and aimed to identify unique pre-operative predictors of early graft and patient survival for primary (1º-pLTx) and re-transplantation (Re-pLTx). STUDY DESIGN: An IRB approved, retrospective study of all consecutive, isolated pLTx patients ≤ 18 years of age was conducted...
February 1, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29407332/antibody-drug-treatment-for-steroid-resistant-rejection-after-pediatric-living-donor-liver-transplantation-a-single-center-experience
#9
Y Hirata, Y Sanada, T Urahashi, Y Ihara, N Yamada, N Okada, T Katano, S Otomo, K Ushijima, K Mizuta
BACKGROUND: Antibody drugs have been used to treat steroid-resistant rejection (SRR) after liver transplantation. Although anti-thymocyte globulin has been used for SRR after liver transplantation in place of muromonab-CD3 since 2011 in Japan, the effectiveness of anti-thymocyte globulin after pediatric living-donor liver transplantation (LDLT) has not yet been reported. The aim of this study was to evaluate the effectiveness of antibody drug treatment for SRR after pediatric LDLT in our single center...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29399279/predicting-early-outcomes-of-liver-transplantation-in-young-children-the-early-study
#10
Rashid Alobaidi, Natalie Anton, Dominic Cave, Elham Khodayari Moez, Ari R Joffe
AIM: To determine potentially modifiable predictors of early outcomes after liver transplantation in children of age < 3 years. METHODS: This study was a retrospective chart review including all consecutive children of age less than 3-years-old having had a liver transplant done at the Western Canadian referral center from June 2005 to June 2015. Pre-specified potential predictor variables and primary and secondary outcomes were recorded using standard definitions and a case report form...
January 27, 2018: World Journal of Hepatology
https://www.readbyqxmd.com/read/29396792/role-of-interventional-radiology-in-managing-pediatric-liver-tumors-part-2-percutaneous-interventions
#11
REVIEW
C Matthew Hawkins, Alexander J Towbin, Derek J Roebuck, Eric J Monroe, Anne E Gill, Avnesh S Thakor, Richard B Towbin, Anne Marie Cahill, Matthew P Lungren
Hepatoblastoma and hepatocellular carcinoma (HCC) are the most common pediatric liver malignancies, with hepatoblastoma occurring more commonly in younger children and HCC occurring more commonly in older children and adolescents. Although surgical resection (including transplant when necessary) and systemic chemotherapy have improved overall survival rate for hepatoblastoma to approximately 80% from 30%, a number of children with this tumor type are not eligible for operative treatment. In contradistinction, pediatric HCC continues to carry a dismal prognosis with an overall 5-year survival rate of 30%...
February 2, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29395171/de-novo-allergy-and-immune-mediated-disorders-following-solid-organ-transplantation-prevalence-natural-history-and-risk-factors
#12
Nufar Marcus, Achiya Z Amir, Eyal Grunebaum, Anne Dipchand, Diane Hebert, Vicky L Ng, Thomas Walters, Yaron Avitzur
OBJECTIVES: To describe the prevalence, natural course, outcome, and risk factors of post-transplant de novo allergy and autoimmunity. STUDY DESIGN: A cross-sectional, cohort study of all children (<18 years) who underwent a solid-organ transplantation, between 2000 and 2012, in a single transplant center, with a follow-up period of 6 months or more post-transplant and without history of allergy or immune-mediated disorder pretransplant. RESULTS: A total of 626 eligible patients were screened, and 273 patients (160 males; 59%) met the inclusion criteria; this included 111 liver, 103 heart, 52 kidney, and 7 multivisceral recipients...
January 22, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29391313/post-transplant-malignancies-in-pediatric-liver-transplant-recipients-experience-of-two-centers-in-turkey
#13
Miray Karakoyun, Şebnem Önen, Maşallah Baran, Murat Çakır, Çiğdem Ömür Ecevit, Murat Kılıç, Mehmet Kantar, Serap Aksoylar, Funda Özgenç, Sema Aydoğdu
BACKGROUND/AIMS: A liver transplant is the preferred treatment for patients with end-stage liver disease, as it usually results in longterm survival. However, due to the use of chronic immunosuppressive therapy, which is necessary to prevent rejection, de novo cancer is a major risk after transplantation. The aim of this study was to assess the incidence of post-transplant malignancies in children after liver transplantations. MATERIALS AND METHODS: The study group consisted of 206 liver transplant recipients, with no history of cancer, including hepatocellular carcinoma, in two liver transplantation centers in Turkey between 1997 and 2015...
January 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29390386/hemophagocytic-lymphohistiocytosis-in-an-adult-kidney-transplant-recipient-successfully-treated-by-plasmapheresis-a-case-report-and-review-of-the-literature
#14
Christian Nusshag, Christian Morath, Martin Zeier, Markus A Weigand, Uta Merle, Thorsten Brenner
RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease entity primarily described in children, but not less relevant in adults. It is characterized by a misdirected activation of the immune system, resulting in an uncontrolled cytokine release from macrophages and cytotoxic T-cells (CTLs). Primary HLH relies on a genetic predisposition, whereas secondary HLH develops in the context of infections, malignancies or autoimmune diseases. However, the awareness and therapeutic knowledge for HLH in adulthood is limited...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29382475/-autoimmune-hepatitis-in-the-pediatric-age
#15
REVIEW
Rubén Peña-Vélez, Enory Almanza-Miranda
In pediatrics, autoimmune hepatitis and sclerosing cholangitis are liver disorders with an immunological damage mechanism. Autoimmune hepatitis is a disease of unknown etiology characterized by interface hepatitis, hypergammaglobulinemia, circulating autoantibodies and a favorable response to immunosuppression. It is an eminently pediatric disease with a prevalent condition in young women. Therapy should be instituted promptly to prevent rapid deterioration, promote remission of disease and long-term survival...
September 2017: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29380468/trends-in-pediatric-liver-transplant-donors-and-deceased-donor-circumstance-of-death-in-the-united-states-2002-2015
#16
Dor Yoeli, Matthew Goss, Nhu Thao N Galván, Moreshwar S Desai, Tamir A Miloh, Abbas Rana
While much of the discussion regarding expanding the donor pool for pediatric liver transplantation has surrounded the use of technical variant grafts, little attention has been directed toward changes in the deceased donor population. The aim of this study was to investigate trends in the circumstance of the death of deceased donors used for pediatric liver transplantation. All pediatric liver transplant recipients transplanted between 2002 and 2015 were identified in the UNOS database and were categorized based on the donor circumstance of death...
January 30, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29380059/post-transplantation-development-of-food-allergies
#17
REVIEW
Erik N Newman, Rafael Firszt
PURPOSE OF REVIEW: The development of food allergies is increasingly being recognized as a post-solid organ transplant complication. In this article, we review the spectrum of post-transplant food allergy development and the proposed mechanisms for de novo food allergies and the clinical significance they pose. RECENT FINDINGS: The development of new food allergies is disproportionately associated with pediatric liver transplants, where it occurs in up to 38% of select populations...
January 29, 2018: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/29377411/waiting-list-mortality-of-young-patients-with-biliary-atresia-competing-risk-analysis-of-an-eurotransplant-registry-based-cohort
#18
Hubert P J van der Doef, Patrick F van Rheenen, M van Rosmalen, Xavier Rogiers, Henkjan J Verkade
INTRODUCTION: Liver transplantation (LTx) is the standard treatment for biliary atresia (BA) patients with end-stage liver disease. The prognosis after LTx has steadily improved, but overall prognosis of BA-patients is also determined by mortality before LTx. We aimed to quantify mortality in young BA-patients on the Eurotransplant waiting list and to determine the effect of disease severity and age at time of listing on pretransplant mortality. METHODS: We used a cohort study design, which incorporated data from the Eurotransplant registry...
January 29, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29373179/post-transplant-outcomes-in-pediatric-ventricular-assist-device-patients-a-pedimacs-pediatric-heart-transplant-study-linkage-analysis
#19
David L Sutcliffe, Elizabeth Pruitt, Ryan S Cantor, Justin Godown, John Lane, Mark W Turrentine, Sabrina P Law, Jodie L Lantz, James K Kirklin, Daniel Bernstein, Elizabeth D Blume
BACKGROUND: Pediatric ventricular assist device (VAD) support as bridge to transplant has improved waitlist survival, but the effects of pre-implant status and VAD-related events on post-transplant outcomes have not been assessed. This study is a linkage analysis between the PediMACS and Pediatric Heart Transplant Study databases to determine the effects of VAD course on post-transplant outcomes. METHODS: Database linkage between October 1, 2012 and December 31, 2015 identified 147 transplanted VAD patients, the primary study group...
December 13, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29369488/transient-elastography-for-non-invasive-evaluation-of-post-transplant-liver-graft-fibrosis-in-children
#20
Tiziana Vinciguerra, Andrea Brunati, Ezio David, Filomena Longo, Michele Pinon, Fulvio Ricceri, Luisa Castellino, Antonio Piga, Maria Teresa Giraudo, Francesco Tandoi, Fabio Cisarò, Dominic Dell Olio, Giuseppe Isolato, Renato Romagnoli, Mauro Salizzoni, Pier Luigi Calvo
As graft survival in pediatric LT is often affected by progressive fibrosis, numerous centers carry out protocol liver biopsies. Follow-up biopsy protocols differ from center to center, but all biopsies are progressively spaced out, as time from transplant increases. Therefore, there is a need for non-invasive techniques to evaluate graft fibrosis progression in those children who have no clinical or serological signs of liver damage. Indirect markers, such as the APRI, should be relied on with caution because their sensitivity in predicting fibrosis can be strongly influenced by the etiology of liver disease, severity of fibrosis, and patient age...
January 25, 2018: Pediatric Transplantation
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