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Pediatric liver infection

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
Karoly Toth, Jacqueline F Spencer, Baoling Ying, Ann E Tollefson, Caroll B Hartline, Eric T Richard, Jiajun Fan, Jinglei Lyu, Boris A Kashemirov, Cheryl Harteg, Dawn Reyna, Elke Lipka, Mark N Prichard, Charles E McKenna, William S M Wold
Human adenoviruses (AdV) cause generally mild infections of the respiratory and GI tracts as well as some other tissues. However, AdV can cause serious infection in severely immunosuppressed individuals, especially pediatric patients undergoing allogeneic hematopoietic stem cell transplantation, where mortality rates are up to 80% with disseminated disease. Despite the seriousness of AdV disease, there are no drugs approved specifically to treat AdV infections. We report here that USC-087, an N-alkyl tyrosinamide phosphonate ester prodrug of HPMPA, the adenine analog of cidofovir, is highly effective against multiple AdV types in cell culture...
March 3, 2018: Antiviral Research
Stephanie E Cordts, Lukas Schneble, Paul Schnitzler, Jürgen J Wenzel, Tobias Vinke, Susanne Rieger, Alexander Fichtner, Burkhard Tönshoff, Britta Höcker
BACKGROUND: Hepatitis E virus (HEV) infection in immunocompromised patients such as solid organ transplant recipients may bear a high risk of becoming a chronic infection with progression to liver cirrhosis. So far, data on HEV infection in pediatric renal transplant recipients are limited. METHODS: This single-center cohort study investigated period prevalence, morbidity, and treatment of HEV infection in 90 pediatric renal allograft recipients aged 9.9 ± 5...
March 2, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Akash Deep, Romit Saxena, Bipin Jose
Acute kidney injury (AKI) is a common accompaniment in patients with liver disease. The causes, risk factors, manifestations and management of AKI in these patients vary according to the liver disease in question (acute liver failure, acute-on-chronic liver failure, post-liver transplantation or metabolic liver disease). There are multiple causes of AKI in patients with liver disease-pre-renal, acute tubular necrosis, post-renal, drug-induced renal failure and hepatorenal syndrome (HRS). Definitions of AKI in liver failure are periodically revised and updated, but pediatric definitions have still to see the light of the day...
March 1, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Jingtao Cui, Wenjuan Yan, Shaoxia Xu, Qiaofeng Wang, Weihong Zhang, Wenjing Liu, Anping Ni
BACKGROUND: Epstein-Barr virus (EBV) is associated with nasopharyngeal carcinoma (NPC) which is prevalent in South China, and its association with systemic lupus erythematosus (SLE) or other autoimmune diseases has not been studied in the mainland of China. The EBV serological tests have been performed on patients with various diseases or manifestations for years at our institution and their values need to be evaluated. METHODS: For routine medical purposes, anti-EB viral capsid antigen (VCA) IgG, IgA and IgM antibodies, anti-EBV diffuse early antigen (EA-D) IgA antibodies, and anti-EBV nuclear antigen-1(EBNA-1) IgG antibodies were tested with commercial enzyme-linked immunosorbent assay (ELISA) in patients visiting Peking Union Medical College Hospital between 2013 and 2017...
2018: PloS One
Palittiya Sintusek, Nawarat Posuwan, Piyaporn Wanawongsawad, Suttiruk Jitraruch, Yong Poovorawan, Voranush Chongsrisawat
AIM: To assess the seroprevalence of hepatitis B virus (HBV) immunity among previously vaccinated pediatric liver transplant recipients and present a case report of de novo hepatitis B infection after liver transplantation. METHODS: This study focused on children with chronic liver diseases who received primary hepatitis B immunization and had a complete dataset of anti-HBs before and after liver transplantation between May 2001 and June 2017. Medical records were retrospectively reviewed for potential factors relating to HBV immunity loss...
February 14, 2018: World Journal of Gastroenterology: WJG
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
Ruiping Zhang, Jungang Liu, Yizheng Wang, Lirong Cao, Chunquan Cai
The most common procedure to deal with hydrocephalus is ventriculoperitoneal (VP) shunt. The purpose of the shunt is to drain cerebrospinal fluid from cerebral ventricles to abdominal cavity. Many complications of VP shunts have been reported such as infection, obstruction, overdrainage. Abdominal complications occur in ~15-25% of VP shunts in pediatric patients, such as peritonitis, hernia, abscess, perforated colon, perforated bladder and abdominal pseudocyst. However, sub-capsular effusion of liver is a rare complication of VP shunt...
October 2017: Journal of Surgical Case Reports
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
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
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
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)
Jiabao Liang, Pengcheng Shi, Xutao Guo, Jie Li, Lingli He, Yan Wang, Qi Wei, Fen Huang, Zhiping Fan, Bing Xu
Data from clinical trials suggest that polyethylene glycol-conjugated asparaginase (PEG asparaginase) should be recommended as a replacement for Escherichia coli (E. coli) asparaginase in the treatment of pediatric acute lymphoblastic leukemia (ALL) due to its prolonged effect, similar safety profile and convenience. The present study investigated the efficacy and safety of PEG asparaginase in adolescents and adults with newly diagnosed ALL. The clinical data of 122 patients, ≥14 years old with de novo ALL, who received either PEG asparaginase or E...
January 2018: Oncology Letters
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
Catarina Salgado, Ana Margarida Garcia, Catarina Rúbio, Florbela Cunha
Infectious mononucleosis is one of the major clinical manifestations of Epstein-Barr virus infection. In this syndrome, elevation of liver transaminase levels is common but cholestasis is rare, with few cases described in the literature. We present the case of a 14-year-old female adolescent, admitted to the Emergency Room with fever, odynophagia and cervical adenomegaly. She was treated with amoxicillin and two days later he presented with jaundice. The analytical evaluation was compatible with cholestatic hepatitis and abdominal ultrasound revealed hepatosplenomegaly without dilatation of the bile ducts...
December 29, 2017: Acta Médica Portuguesa
Danielle Wendel, Melissa Mortensen, Alisha Harmeson, Michele L Shaffer, Evelyn Hsu, Simon Horslen
OBJECTIVE: Malnutrition is a common complication of end-stage liver disease (ESLD) associated with poor liver transplant outcomes. Nasogastric feeds are used for nutritional supplementation, but some patients remain malnourished. Parenteral nutrition (PN) can be effective, but has potential complications. The primary objective was to evaluate the effect of PN on anthropometric measures in children with ESLD awaiting liver transplant. Secondary objectives were evaluation of PN-associated complications, liver function tests, pediatric end-stage liver disease scores, waitlist time, and post-transplant length of stay (total and time in the intensive care unit)...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
Mingxuan Feng, Ping Wan, Bijun Qiu, Tao Zhou, Yi Luo, Lihong Gu, Jiachang Chi, Chengpeng Zhong, Yefeng Lu, Jianjun Zhang, Qiang Xia
BACKGROUND: An atretic or hypoplastic portal vein (PV) represents a challenge for PV reconstruction in pediatric living donor liver transplantation (LDLT). Several PV venoplastic techniques have been developed. However, we still seek improved venoplastic techniques with better efficacy and compatibility. METHOD: From June 2016 to July 2017, 271 LDLT procedures were performed at the Department of Liver Surgery, Ren Ji Hospital. A total of 16 consecutive children with atretic and sclerotic PVs underwent a novel technique - the autogenous PV patch plastic technique...
January 12, 2018: Liver Transplantation
Yilun Sun, Rachael L Huskey, Li Tang, Hiroto Inaba, Aditya H Gaur, Raul Ribeiro, Jeffrey E Rubnitz, Joshua Wolf
Children and adolescents with acute myeloid leukemia (AML) are at risk of life-threatening bacterial infections, especially with viridans group streptococci. Primary antibacterial prophylaxis with vancomycin-based regimens reduces this risk but might increase the risks of renal or liver toxicity or Clostridium difficile infection (CDI). A retrospective review of data for patients treated for newly diagnosed AML at St. Jude Children's Research Hospital between 2002 and 2008 was conducted. Nephrotoxicity was classified according to pediatric risk, injury, failure, loss, and end-stage renal disease (pRIFLE) criteria and hepatotoxicity according to Common Terminology Criteria for Adverse Events (CTCAE) criteria...
March 2018: Antimicrobial Agents and Chemotherapy
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
March 2018: Annals of Thoracic Surgery
Sohsaku Yamanouchi, Takahisa Kimata, Jiro Kino, Tetsuya Kitao, Chikushi Suruda, Shoji Tsuji, Hiroyuki Kurosawa, Yoshiaki Hirayama, Akihiko Saito, Kazunari Kaneko
BackgroundFebrile urinary tract infection (fUTI) in children may cause renal scarring. This study aimed to investigate the usefulness of urinary biomarkers for diagnosing renal scarring after fUTI.MethodsThirty-seven children (median age: 1.36 years, range: 0.52-12.17 years, 25 boys) with a history of fUTI, who underwent renal scintigraphy for 4 months or longer after the last episode of fUTI, were analyzed. A spot urine sample was obtained on the day of renal scintigraphy to measure levels of total protein, N-acetyl-β-D-glucosaminidase (NAG), β2 -microglobulin (BMG), neutrophil gelatinase-associated lipocalin (NGAL), liver-type fatty acid binding protein (L-FABP), and C-megalin (full-length megalin)...
December 6, 2017: Pediatric Research
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