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Liver transplantation pediatric

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https://www.readbyqxmd.com/read/29663585/perioperative-anticoagulation-practices-for-pediatric-liver-transplantation
#1
Stylianos Voulgarelis, Bernadette Vitola, Stacee M Lerret, Johnny C Hong, John P Scott
Despite continued advancements in perioperative care for pediatric liver transplant (LT), graft-threatening vascular occlusion events including hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT) remain a source of significant morbidity and mortality. Perioperative anticoagulation is commonly used for the prevention of HAT and PVT, but evidence-based guidelines are lacking. The goals of this survey were to determine the frequency of use of an anticoagulation protocol and to describe variation in anticoagulation practices among pediatric LT centers...
April 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29663565/risk-factors-for-early-invasive-fungal-infections-in-pediatric-liver-transplant-recipients
#2
Yehonatan Pasternak, Shiri Rubin, Efraim Bilavsky, Yael Mozer-Glassberg, Itzhak Levy, Elhanan Nahum, Eran Rom, Michael Gurevich, Haim Ben-Zvi, Liat Ashkenazi-Hoffnung
BACKGROUND: Invasive fungal infections (IFIs) post-liver transplantation are a frequent cause of morbidity and mortality;however, studies reporting on these infections in the pediatric population are scarce. OBJECTIVE: To investigate the incidence and risk factors of IFIs in pediatric liver transplant recipients during the early post-transplantation period (≤3 months). MATERIALS AND METHODS: Data were collected for all pediatric liver transplant recipients registered in a national transplantation center from 2004-2014...
April 17, 2018: Mycoses
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#3
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29651794/celiac-trunk-and-common-hepatic-artery-variations-in-children-an-analysis-with-ct-angiography
#4
Emine Caliskan, Turker Acar, Mehmet Ozturk, Zuhal Bayramoglu, Ravza Yilmaz, Filiz Elbuken, Ibrahim Adaletli
BACKGROUND: Understanding the celiac trunk and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyze the prevalence of celiac trunk (CeT) and common hepatic artery (CHA) variations in the pediatric population. MATERIALS AND METHODS: One hundred and seventy-four children (174) who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analyzed retrospectively...
April 13, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29624817/fatal-hyperammonemia-associated-with-disseminated-serratia-marcescens-infection-in-a-pediatric-liver-transplant-recipient
#5
Stephen Mouat, Jonathan Bishop, Emma Glamuzina, Simon Chin, Emma J Best, Helen M Evans
Hyperammonemia is a rare and important complication post-liver transplantation. We review a case of a 5-month-old boy with biliary atresia who received a split liver transplant following a variceal bleed. The transplant was complicated by recurrent portal vein thrombosis. Colonized with Serratia marcescens pretransplant, he developed disseminated infection associated with very high levels of ammonia that led to his death. It is important to be aware of serum ammonia levels in patients with portal vein thrombosis, particularly in the setting of gastrointestinal bleeding and sepsis...
April 6, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29621122/survival-time-to-biopsy-proven-acute-rejection-and-tacrolimus-adverse-drug-reactions-in-pediatric-liver-transplantation
#6
Natalia Riva, Marcelo Dip, Esteban Halac, Paulo Cáceres Guido, Jean Baptiste Woillard, Nieves Licciardone, Debora Chan, Jefferson Buendía, Daniela Borgnia, Andrea Bosaleh, María Teresa de Davila, Oscar Imventarza, Paula Schaiquevich
BACKGROUND: Despite advances in surgical procedures and the optimization of immunosuppressive therapies in pediatric liver transplantation, acute rejection (AR) and serious adverse drug reaction (ADR) to tacrolimus still contribute to morbidity and mortality. Identifying risk factors of safety and efficacy parameters may help in optimizing individual immunosuppressive therapies. This study aimed to identify peritransplant predictors of AR and factors related to the risk of ADR to tacrolimus in a large Latin-American cohort of pediatric liver transplant patients...
April 3, 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29620615/long-term-outcomes-of-abo-incompatible-pediatric-living-donor-liver-transplantation
#7
Masaki Honda, Yasuhiko Sugawara, Masashi Kadohisa, Keita Shimata, Masataka Sakisaka, Daiki Yoshii, Keiichi Uto, Shintaro Hayashida, Yuki Ohya, Hidekazu Yamamoto, Hirotoshi Yamamoto, Yukihiro Inomata, Taizo Hibi
BACKGROUND: ABO-incompatible (ABOi) living donor liver transplantation (LDLT) have been performed to compensate for donor shortage. To date, few studies have reported detailed B cell desensitization protocols and long-term outcomes of ABOi pediatric LDLT. METHODS: Twenty-nine pediatric ABOi LDLT recipients were retrospectively analyzed. We compared the clinical outcomes between ABOi (n = 29) and non-ABOi (n = 131) pediatric LDLT recipients. Furthermore, we evaluated the safety and efficacy of our rituximab-based regimen for ABOi pediatric LDLT (2 ≤ age < 18, n = 10)...
April 3, 2018: Transplantation
https://www.readbyqxmd.com/read/29620594/pediatric-liver-transplant-teams-coping-with-patient-death
#8
Sarah E Duncan, Ronen Arnon, Christie DiPietrantonio, Katie Ehrlich, Christopher S Knight, Jaime Chu, Rachel A Annunziato
OBJECTIVES: Coping with patient death among pediatric liver transplant teams has received little attention despite general recognition of the potentially negative emotional consequences associated with such loss. The purpose of this study was to investigate 1) the ways in which members of pediatric liver transplant teams cope with the death of patients on the waitlist and post-transplant and 2) the institutional resources available to facilitate this coping. METHODS: Participants included 120 physicians, nurses, and mental health professionals from multiple transplant centers across the United States...
April 3, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29613889/extracorporeal-membrane-oxygenation-in-a-pediatric-patient-with-hepatopulmonary-syndrome-and-interrupted-inferior-vena-cava-after-living-related-liver-donation
#9
Michael R Phillips, Marc Priest, Christopher Beaty, Robert Parker, Marisa Meyer, Stephen Dunn, Curtis D Froehlich, Daniel R Dirnberger, Abigail E Martin, Mark T Ogino
Extracorporeal membrane oxygenation (ECMO) is used for cardiopulmonary dysfunction. Hepatopulmonary syndrome (HPS) occurs in the setting of liver failure and may cause hypoxemia. Previous reports have described the use of ECMO for HPS after liver transplant. Our patient is a 19-month-old female with biliary atresia, an interrupted inferior vena cava, and HPS on 8 liters per minute of high-flow oxygen. Following liver transplantation, her postoperative course was complicated by severe hypoxemia requiring ECMO...
March 30, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29607581/roux-en-y-enterolith-leading-to-obstruction-and-ischemic-necrosis-after-pediatric-orthotopic-liver-transplantation
#10
Ralph C Quillin, Advaith Bongu, Vania Kasper, Jennifer M Vittorio, Mercedes Martinez, Steven J Lobritto, Adam D Griesemer, James V Guarrera
Biliary complications are a common cause of morbidity after liver transplantation, with biliary stone formation being a known occurrence generally upstream of a stricture. A 12-year-old boy, who underwent an orthotopic liver transplantation at 11 months of age for biliary atresia, presented acutely with fever and abdominal pain. Cross-sectional imaging revealed Roux-en-Y limb dilatation and thickening. He was explored and was found to have an ischemic Roux limb secondary to an obstructing enterolith. A segmental bowel resection and revision of his hepaticojejunostomy was performed...
April 1, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29604217/receipt-of-a-pediatric-liver-offer-as-the-first-offer-reduces-waitlist-mortality-for-adult-women
#11
Jin Ge, Richard Gilroy, Jennifer C Lai
BACKGROUND AND AIMS: In liver transplantation, adults with small stature have a greater susceptibility to waitlist mortality. This may explain the persistent waitlist mortality disparity that exists for women. We hypothesized that women who receive early offers of pediatric donor livers have improved waitlist survival, and that preferentially offering these organs to women mitigates this sex-based disparity. METHODS: We analyzed donor liver offers from 2010 to 2014...
March 31, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29594739/the-ibd-and-psc-phenotypes-of-psc-ibd
#12
REVIEW
Amanda Ricciuto, Binita M Kamath, Anne M Griffiths
PURPOSE OF REVIEW: To review the characteristics of IBD and PSC that occur in association, as well as their reciprocal influences on disease evolution, in adult and pediatric populations. RECENT FINDINGS: IBD co-existing with PSC is genetically and clinically distinct from IBD alone. It is frequently characterized by pancolitis, rectal sparing, and possibly backwash ileitis, as well as a threefold increased risk of colorectal dysplasia. Adults and children with colitis and PSC appear to be at increased risk of active endoscopic and histologic disease in the absence of symptoms compared to individuals without PSC...
March 28, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29579867/multicentric-study-of-the-andalusian-experience-in-polycystic-liver-disease-as-indication-for-liver-transplantation
#13
S Dios-Barbeito, M Domínguez-Bastante, A Moreno-Navas, F J León-Díaz, Y Fundora-Suárez, F J Briceño-Delgado, M Pitarch-Martínez, M Á Gómez-Bravo
BACKGROUND: The purpose of this study was to determine the morbidity and survival in patients with polycystic liver disease (PLD) undergoing liver transplantation (LT) in 4 Spanish hospitals. METHODS: A multicentric retrospective study using a prospective database was designed including 19 LTs after PLD diagnosis performed from January 1, 1990, to December 31, 2016. Pediatric patients were excluded from the analysis. RESULTS: Of the included patients, 63...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579809/access-to-grafts-in-a-liver-transplant-center-does-it-rely-on-the-severity-of-the-waiting-list-population
#14
N I Daciuk, E G Quiñonez, M Poupard, R M Vergara Sandoval, F J Mattera
BACKGROUND: The number of transplants performed relies, partially, on recipients' variables on the waiting list. The goal of this study was to compare recipients from a high-volume liver center in Argentina with the rest of the country. METHODS: This study was a retrospective analysis of liver transplant recipients nationally between January 2013 and April 2017. It involved extracting data from the open database CRESI-SINTRA (the Argentinian database of the National Procurement Organization, an equivalent to the United Network for Organ Sharing); expressing results by percentages, medians, and interquartile ranges (IQRs); and comparing the national population with the population transplanted at Hospital El Cruce (HEC)...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29577520/the-impact-of-thromboelastography-on-resuscitation-in-pediatric-liver-transplantation
#15
Joseph Sujka, Katherine W Gonzalez, Kayla L Curiel, James Daniel, Ryan T Fischer, Walter S Andrews, Brian M Wicklund, Richard J Hendrickson
Although TEG directs effective resuscitation in adult surgical patients, pediatric data are lacking. We performed a retrospective comparative review of the effect of TEG on blood product utilization and outcomes following pediatric liver transplantation in 38 patients between 2008 and 2014. Diagnoses, laboratory values, fluid and blood product use, and outcomes were examined. Nineteen patients underwent liver transplantation prior to the implementation of TEG, and 19 had perioperative TEG. The most common indications for transplant were BA (n = 14), HB (n = 7), and metabolic disorders (n = 7)...
March 26, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29575295/physical-activity-experiences-in-children-post-liver-transplant-developing-a-foundation-for-rehabilitation-interventions
#16
Catherine Patterson, Stephanie So, Maria DeAngelis, Emily Ghent, Degen Southmayd, Christine Carpenter
PA plays an important role in the physical and psychosocial health of children and is beneficial in the treatment and prevention of comorbidities associated with transplantation. Despite this, PA participation in pediatric liver transplant recipients remains low compared to healthy peers. This qualitative-focused mixed-methods study explored the PA experiences and parental perception of these experiences, including perceived facilitators and barriers to PA in children post-liver transplant. Eighteen participants (9 children [median age 10...
March 25, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29575286/planar-xanthomas-secondary-to-post-transplantation-cholangiopathy-in-a-16-month-old-boy
#17
Nirali Patel, Adam Norberg, Marcia Hogeling
Planar xanthomas in children represent rare dermatologic findings associated with abnormalities in lipid metabolism. While planar xanthomas in Alagille's syndrome have been well described in the literature, there have been no cases reported of eruptive xanthomas in pediatric liver transplant patients. Herein we report a case of a 16-month-old boy status post-liver transplantation who presents with planar xanthomas secondary to cholangiopathy. A brief review of xanthomas and the related literature is also provided...
March 25, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29545104/long-term-outcome-of-portal-vein-stent-placement-in-pediatric-liver-transplant-recipients-a-comparison-with-balloon-angioplasty
#18
Dong Jae Shim, Gi-Young Ko, Kyu-Bo Sung, Dong Il Gwon, Heung Kyu Ko
PURPOSE: To evaluate the long-term efficacy of stent placement versus balloon angioplasty for portal vein (PV) stenosis in pediatric liver transplant (LT) recipients. MATERIALS AND METHODS: Fifty patients (<18 years old; median, 14 months) who underwent percutaneous transhepatic balloon angioplasty (n = 12), transhepatic stent placement (n = 18), or intraoperative transmesenteric stent placement (n = 20) between 1994 and 2015 were retrospectively analyzed...
March 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29542229/association-of-post-transplant-donor-specific-hla-antibody-with-liver-graft-fibrosis-during-long-term-follow-up-after-pediatric-liver-transplantation
#19
Kazuaki Tokodai, Shigehito Miyagi, Chikashi Nakanishi, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Keigo Murakami, Hironobu Sasano, Masafumi Goto, Michiaki Unno, Takashi Kamei
The aim of this study was to evaluate the significance of post-transplant DSA as a predictor of liver fibrosis during long-term follow-up after pediatric LT. We evaluated the histological findings in 18 LT recipients who underwent liver biopsy after DSA screening. Liver fibrosis was scored based on the METAVIR fibrosis staging. Patients were divided into 2 groups based on histological findings, and clinical characteristics among patients with liver fibrosis were assessed. Of 18 patients, 7 were included in the fibrosis group...
March 14, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29538674/a-multicenter-consortium-to-define-the-epidemiology-and-outcomes-of-pediatric-solid-organ-transplant-recipients-with-inpatient-respiratory-virus-infection
#20
Lara Danziger-Isakov, William J Steinbach, Grant Paulsen, Flor M Munoz, Leigh R Sweet, Michael Green, Marian G Michaels, Janet A Englund, Alastair Murray, Natasha Halasa, Daniel E Dulek, Rebecca Pellett Madan, Betsy C Herold, Brian T Fisher
Background: Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear. Methods: A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant...
March 10, 2018: Journal of the Pediatric Infectious Diseases Society
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