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Pediatric Transplant

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https://www.readbyqxmd.com/read/29243013/exercise-performance-in-pediatric-liver-transplant-recipients-and-its-related-cardiac-function
#1
Seyed Mohsen Dehghani, Mitra Moshref, Hamid Amoozgar, Seyed Ali Malek Hoseini, Saman Nikeghbalian
The aim of this study was to evaluate an exercise test in pediatric liver transplant recipients and its relation to their cardiac function. This cross-sectional study was conducted on 58 children who had successfully undergone orthotopic liver transplantation at least 6 months prior to the study, with the same age and gender-matched control group. M-mode, Doppler, tissue Doppler echocardiography and an exercise test were performed for all the participants. The VO2 values and METS in patients were less than the control (P = 0...
December 14, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29242302/a-distinct-subtype-of-epstein-barr-virus-positive-t-nk-cell-lymphoproliferative-disorder-adult-patients-with-chronic-active-epstein-barr-virus-infection-like-features
#2
Keisuke Kawamoto, Hiroaki Miyoshi, Takaharu Suzuki, Yasuji Kozai, Koji Kato, Masaharu Miyahara, Toshiaki Yujiri, Naoki Oishi, Ilseung Choi, Katsumichi Fujimaki, Tsuyoshi Muta, Masaaki Kume, Sayaka Moriguchi, Shinobu Tamura, Takeharu Kato, Hiroyuki Tagawa, Junya Makiyama, Yuji Kanisawa, Yuya Sasaki, Daisuke Kurita, Kyohei Yamada, Joji Shimono, Hirohito Sone, Jun Takizawa, Masao Seto, Hiroshi Kimura, Koichi Ohshima
The characteristics of adult patients with chronic active Epstein-Barr virus infection (adult-onset CAEBV) are poorly recognized, hindering early diagnosis and an improved prognosis. Adult-onset CAEBV (n = 54) diagnosed between 2005 and 2015 were conducted. Adult-onset was defined as an estimated age of onset ≥15 years. To characterize the clinical features of adult-onset CAEBV, we compared them to those of pediatric-onset (estimated age of onset <15 years) patients (n = 75). We compared the prognosis of adult-onset CAEBV with that for patients with nasal-type (n = 37) and non-nasal-type (n = 45) extranodal NK/T-cell lymphoma (ENKTL)...
December 14, 2017: Haematologica
https://www.readbyqxmd.com/read/29240630/in-vitro-characterization-of-the-pittsburgh-pediatric-ambulatory-lung
#3
Ryan A Orizondo, Alexandra G May, Shalv P Madhani, Brian J Frankowski, Greg W Burgreen, Peter D Wearden, William J Federspiel
Acute and chronic respiratory failure are a significant source of pediatric morbidity and mortality. Current respiratory support options used to bridge children to lung recovery or transplantation typically render them bedridden and can worsen long-term patient outcomes. The Pittsburgh Pediatric Ambulatory Lung (P-PAL) is a wearable pediatric blood pump and oxygenator (0.3 m surface area) integrated into a single compact unit that enables patient ambulation. The P-PAL is intended for long-term use and designed to provide up to 90% of respiratory support in children weighing 5-25 kg...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29240626/first-report-of-biventricular-percutaneous-impella-ventricular-assist-device-use-in-pediatric-patients
#4
Javier J Lasa, Daniel A Castellanos, Susan W Denfield, William J Dreyer, Sebastian C Tume, Henri Justino, Athar M Qureshi
There is a growing interest in the use of percutaneously delivered ventricular assist devices (PVAD) in the pediatric patient population. A 16 year old female and 18 year old male both status post heart transplantation presented with evidence of graft rejection and acute severe global systolic and diastolic heart failure necessitating hemodynamic catheterization and inotropic support. Both underwent percutaneous Impella CP LVAD (Abiomed, Danvers, MA) placement with close monitoring of right ventricular function...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29239916/early-experience-with-clinimacs-prodigy-ccs-ifn-gamma-system-in-selection-of-virus-specific-t-cells-from-third-party-donors-for-pediatric-patients-with-severe-viral-infections-after-hematopoietic-stem-cell-transplantation
#5
Krisztián Kállay, Csaba Kassa, Marienn Réti, Éva Karászi, János Sinkó, Vera Goda, Anita Stréhn, Katalin Csordás, Orsolya Horváth, Attila Szederjesi, Szabolcs Tasnády, Apor Hardi, Gergely Kriván
Viral reactivation is a frequent complication of allogeneic hematopoietic stem cell transplantation especially in children. For refractory cases, rapid virus-specific T-cell therapy would be ideally implemented within a few days. Over the course of a year in our pediatric cohort of 43 allogeneic transplantation, 9 patients fulfilled criteria for virus-specific T-cell therapy. Viral infections were due to cytomegalovirus (CMV) in 3, Epstein-Barr virus (EBV) in 2, and adenovirus (AdV) in 1 case, whereas >1 virus was detected in 3 cases...
December 12, 2017: Journal of Immunotherapy
https://www.readbyqxmd.com/read/29239497/clinical-outcomes-of-unrelated-cord-blood-transplantation-in-children-with-malignant-and-non-malignant-diseases-multicenter-experience-in-china
#6
Xiangfeng Tang, Jianpei Fang, Jie Yu, Zhiguang Li, Jing Chen, Xin Sun, Yiping Zhu, Shaoyan Hu, Maoquan Qin, Yongmin Tang, Zuo Luan
This multicenter retrospective study included 184 children with malignant and non-malignant diseases who underwent UCBT between January 1998 and August 2012. The malignant disease group included 101 children with ALL, AML, CML, JMML, and MDS, and the non-malignant disease group included 83 children with PID, β-thalassemia, IMD BMF, and HLH. The median duration to neutrophil and platelet engraftment was 16 and 35 days in the malignant disease group vs 15 and 38 days in the non-malignant disease group. The cumulative incidence of grade II-IV aGVHD and cGVHD was 25...
December 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29239087/danaparoid-reduces-transplant-related-mortality-in-stem-cell-transplantation-for-children
#7
Koji Kato, Hirotoshi Sakaguchi, Hideki Muramatsu, Yuko Sekiya, Nozomu Kawashima, Atsushi Narita, Sayoko Doisaki, Nobuhiro Watanabe, Nao Yoshida, Kimikazu Matsumoto
In SCT, death from transplant-related complications is the major obstacle hindering improvement of transplant outcomes, and proper supportive care is essential to reduce TRM. The transplant outcomes of 210 pediatric patients with malignant and non-malignant disorders who consecutively underwent SCT in our institution from 2000 to 2013 were analyzed. The transplant years were divided into three periods: A (2000-2004), B (2005-2008), and C (2009-2013), and an improvement in 5-year OS and a decrease in 5-year TRM were observed over these time periods; that is, OS was 61...
December 13, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29238995/test-dose-pharmacokinetics-in-pediatric-patients-receiving-once-daily-iv-busulfan-conditioning-for-hematopoietic-stem-cell-transplant-a-reliable-approach
#8
Kristina M Brooks, Paul Jarosinski, Thomas Hughes, Elizabeth Kang, Nirali N Shah, John B Le Gall, Dennis D Hickstein, Suk See De Ravin, Jomy M George, Parag Kumar
Intravenous (IV) busulfan test dose pharmacokinetics (PK) has been shown to accurately predict once-daily dose requirements and improve outcomes in adult transplant patients, but there are limited data to support this approach in children. Test doses of busulfan ∼0.8 mg/kg were infused over 2 to 3 hours, followed by serial sampling to 4-6 hours postinfusion in pediatric hematopoietic stem cell transplant recipients (n = 5). Once-daily busulfan doses were calculated based on a myelosuppressive area under the concentration-time curve (AUC) target of ∼3700 to 4000 μmol·min/L and assumed dose-proportionality to the test dose...
December 14, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29232664/vaccination-practices-in-pediatric-dialysis-patients-across-europe-a-european-pediatric-dialysis-working-group-and-european-society-for-pediatric-nephrology-dialysis-working-group-study
#9
Sevcan A Bakkaloğlu, Yesim Özdemir Atikel, Fabio Paglialonga, Constantinos J Stefanidis, Varvara Askiti, Enrico Vidal, Gema Ariceta, Engin Melek, Enrico Verrina, Nikoleta Printza, Karel Vondrak, Aleksandra Zurowska, Ilona Zagozdzon, Mesiha Ekim, Elif Nursel Özmert, Stephanie Dufek, Augustina Jankauskiene, Claus Peter Schmitt, Eszter Lévai, Johan Vande Walle, Nur Canpolat, Tuula Holtta, Michel Fischbach, Guenter Klaus, Christoph Aufricht, Rukshana Shroff, Alberto Edefonti
BACKGROUND: Data on the immunization practices in pediatric chronic kidney disease (CKD) patients are scarce. The purpose of this study was to evaluate current vaccination practices for children on dialysis across European pediatric nephrology centers. METHODS: A total of 18 tertiary pediatric nephrology centers from 12 European countries were included in the study. The data on universal national immunization programs and immunization practices for children with chronic disease or risk were recorded from European Center for Disease Prevention and Control and the World Health Organization...
December 12, 2017: Nephron
https://www.readbyqxmd.com/read/29232040/geographic-disparity-in-kidney-transplantation-under-kas
#10
Sheng Zhou, Allan B Massie, Xun Luo, Jessica M Ruck, Eric K H Chow, Mary G Bowring, Sunjae Bae, Dorry L Segev, Sommer E Gentry
The Kidney Allocation System fundamentally altered kidney allocation, causing a substantial increase in regional and national sharing that we hypothesized might impact geographic disparities. We measured geographic disparity in deceased donor kidney transplant (DDKT) rate under KAS (6/1/2015-12/1/2016), and compared that with pre-KAS (6/1/2013-12/3/2014). We modeled DSA-level DDKT rates with multilevel Poisson regression, adjusting for allocation factors under KAS. Using the model we calculated a novel, improved metric of geographic disparity: the median incidence rate ratio (MIRR) of transplant rate, a measure of DSA-level variation that accounts for patient casemix and is robust to outlier values...
December 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29230826/evolution-of-biventricular-loading-condition-in-pediatric-lvad-patient-a-prospective-and-observational-study
#11
Arianna Di Molfetta, Roberta Iacobelli, Sergio Filippelli, Giorgia Grutter, Gianluigi Perri, Francesca Iodice, Luciano Pasquini, Paolo Guccione, Antonio Amodeo
The aim of this study was to describe the echocardiographic trend of left ventricular (LV) and right ventricular (RV) function after implantation of a pulsatile flow left ventricular assist device (LVAD) in children. From 2013 to 2016, we prospectively evaluated 13 consecutive pediatric Berlin Heart EXCOR LVAD patients. Clinical and echocardiographic data were collected at baseline, within 24 h after implantation and monthly until LVAD explant. Median age and weight at the implantation was 8 (4-23) months and 5 (4...
December 12, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29229171/special-considerations-in-pediatric-kidney-transplantation
#12
REVIEW
Sean A Hebert, Rita D Swinford, David R Hall, Jason K Au, John S Bynon
Universally accepted as the treatment of choice for children needing renal replacement therapy, kidney transplantation affords children the opportunity for an improved quality of life over dialysis therapy. Immunologic and surgical advances over the last 15 years have improved the pediatric patient and kidney graft survival. Unique to pediatrics, congenital genitourinary anomalies are the most common primary diseases leading to kidney failure, many with urological issues. Early urological evaluation for post-transplant bladder dysfunction and emphasis on immunization adherence are the mainstays of pediatric pretransplant and post-transplant evaluations...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29226563/fatal-cardiac-arrest-in-pediatric-heart-transplant-recipients-query-of-the-unos-database
#13
Robert W Loar, Susan W Denfield, Shaine A Morris, Hari P Tunuguntla, Antonio G Cabrera, Jack F Price, Wei Zhang, Katherine Hosek, Jeffrey J Kim, William J Dreyer, Aamir Jeewa
The incidence of death by CA after PHTx is unknown. We aimed to determine the incidence and factors for fatal CA after PHTx, and whether a PM affects survival. Retrospective cohort study utilizing the United Network of Organ Sharing registry of patients transplanted ≤18 years. Multivariable analyses in hazard-function domain and Kaplan-Meier analyses were performed for an outcome of death due to CA. There were 7719 PHTx patients queried. CA was the reported cause of death in 11%. Age ≥13 years at time of transplant, presence of a PM, and depressed EF were identified as significant factors for fatal CA...
December 10, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29226049/unresectable-undifferentiated-embryonal-sarcoma-of-the-liver-in-an-adult-male-treated-with-chemotherapy-and-orthotopic-liver-transplantation
#14
Zarak H Khan, Kamran Ilyas, Hamza H Khan, Haider Ghazanfar, Qulsoom Hussain, Faisal Inayat, Muhammad Yasir, Rizwan Asim
Undifferentiated embryonal sarcoma of the liver (UESL) is a malignancy of mesenchymal origin observed predominantly in the pediatric population and very rarely in adults. We describe the case of a 21-year-old male who presented with acute onset of right upper quadrant pain and distention. Physical examination of the patient revealed right upper quadrant tenderness with the lower border of the liver palpable, 4 cm below the right costal margin. Laboratory tests performed on admission showed that the patient's liver function tests, urinalysis, complete blood count, and basic metabolic panel were within reference range...
October 8, 2017: Curēus
https://www.readbyqxmd.com/read/29224938/subclinical-atherosclerosis-in-pediatric-liver-transplant-recipients-carotid-and-aorta-intima-media-thickness-and-their-predictors
#15
Emily R Perito, Andrew Phelps, Tabitha Vase, Vickie A Feldstein, Robert H Lustig, Philip Rosenthal
OBJECTIVE: To investigate prevalence and predictors of cardiovascular risk in pediatric liver transplant recipients using noninvasive markers of subclinical atherosclerosis: carotid intima-media thickness (cIMT) and aorta intima-media thickness (aIMT). STUDY DESIGN: Cross-sectional study of 88 pediatric liver transplant recipients. The cIMT and aIMT were measured by ultrasound imaging using standardized protocol. RESULTS: Participants were 15...
December 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29224250/multiple-autologous-bone-marrow-derived-cd271-mesenchymal-stem-cell-transplantation-overcomes-drug-resistant-epilepsy-in-children
#16
Olga Milczarek, Danuta Jarocha, Anna Starowicz-Filip, Stanislaw Kwiatkowski, Bogna Badyra, Marcin Majka
There is a need among patients suffering from drug-resistant epilepsy (DRE) for more efficient and less toxic treatments. The objective of the present study was to assess the safety, feasibility, and potential efficacy of autologous bone marrow cell transplantation in pediatric patients with DRE. Two females and two males (11 months to 6 years) were enrolled and underwent a combined therapy consisting of autologous bone marrow nucleated cells (BMNCs) transplantation (intrathecal: 0.5 × 109 ; intravenous: 0...
December 10, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29223859/outcome-of-pediatric-renal-transplantation-in-urological-versus-non-urological-causes-of-end-stage-renal-disease-does-it-matter
#17
Ahmed Aly Hussein, Ahmed Ismail Shoukry, Fatina Fadel, Hani Abdel-Raouf Morsi, Hussein Aly Hussein, Mostafa Sheba, Nada El-Khateeb, Waseem Abou-El Ela, Mohamed El-Sheemy, Kareem Daw, Ahmed Shouman, Amr Lotfy, Hisham Badawy, Mohamed Eissa
INTRODUCTION: Causes for end stage renal disease (ESRD) in children can be categorized into urological causes or non-urological causes. We sought to compare the outcomes of urological and non-urological causes of ESRD in children. METHODS: Patients were divided into two groups: urological causes of ESRD versus non-urological causes of ESRD. All patients and donors had at least 6 months of follow-up. The main outcomes included the effect on complications and renal function...
November 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29223518/synchronous-central-nervous-system-atypical-teratoid-rhabdoid-tumor-and-malignant-rhabdoid-tumor-of-the-kidney-case-report-of-a-long-term-survivor-and-review-of-the-literature
#18
Mohammad H Abu Arja, Priyal Patel, Summit H Shah, Jeffery J Auletta, Erin K Meyer, Suzanne E Conley, Jennifer H Aldrink, Jonathan A Pindrik, Mohamed S AbdelBaki
BACKGROUND: Atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system (CNS) with synchronous or metachronous extra-CNS disease is a rare childhood malignancy with a dismal prognosis. CASE DESCRIPTION: We report a seven-week-old female with metastatic AT/RT and synchronous malignant rhabdoid tumor of the kidney who received an intensive multimodal approach combining surgical resection, intrathecal chemotherapy, and high-dose chemotherapy with autologous peripheral blood stem cell transplant (PBSCT)...
December 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29223439/a-unique-linkage-of-administrative-and-clinical-registry-databases-to-expand-analytic-possibilities-in-pediatric-heart-transplantation-research
#19
Justin Godown, Cary Thurm, Debra A Dodd, Jonathan H Soslow, Brian Feingold, Andrew H Smith, Bret A Mettler, Bryn Thompson, Matt Hall
BACKGROUND: Large clinical, research, and administrative databases are increasingly utilized to facilitate pediatric heart transplant (HTx) research. Linking databases has proven to be a robust strategy across multiple disciplines to expand the possible analyses that can be performed while leveraging the strengths of each dataset. We describe a unique linkage of the Scientific Registry of Transplant Recipients (SRTR) database and the Pediatric Health Information System (PHIS) administrative database to provide a platform to assess resource utilization in pediatric HTx...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#20
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...
December 6, 2017: Annals of Thoracic Surgery
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