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Pediatric Transplant

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https://www.readbyqxmd.com/read/29924261/-resistance-to-ganciclovir-in-cytomegalovirus-infection-after-heart-transplant-case-report
#1
Christian Rojas-Contreras, Gabriel De la Cruz-Ku, Stalin Vilcarromero, Ruben Villacaqui Ayllon, Bryan Valcarcel-Valdivia
Cytomegalovirus infection after a heart transplant is a recurrent medical condition. Its frequency increases when the donors are serum-positive, and the recipients are serum-negative to this virus. In the pediatric population, the infection only develops in a small percentage and the patients rarely present resistance to conventional treatment with ganciclovir and valganciclovir. We presented the first report of a pediatric case of the cytomegalovirus infection resistant to ganciclovir and valganciclovir after a heart transplant in a Peruvian public hospital with an unusual presentation...
January 2018: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/29923857/female-sex-is-associated-with-poor-health-related-quality-of-life-in-children-at-12-months-post-hematopoietic-cell-transplantation
#2
Neel S Bhatt, Ruta Brazauskas, Heather R Tecca, Jenny Vogel, Deborah Mattila, Stephanie J Lee, Mary M Horowitz, J Douglas Rizzo, Bronwen E Shaw
To study the factors associated with poorer health-related quality of life at 1-year post-allogeneic hematopoietic cell transplantation (alloHCT), a secondary analysis of a prospective feasibility study was performed. Pediatric Quality of Life Inventory questionnaires were collected in 76 children undergoing alloHCT at baseline (within 30 d before transplantation), day 100, 6 months, and 12 months posttransplantation. The global score improved post-HCT (baseline: 67.1, 12 mo: 76.6). Females (odds ratio, 6...
June 19, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29923253/comparison-of-survival-outcome-between-donor-types-or-stem-cell-sources-for-childhood-acute-myeloid-leukemia-after-allogenic-hematopoietic-stem-cell-transplantation-a-multicenter-retrospective-study-of-study-alliance-of-yeungnam-pediatric-hematology-oncology
#3
Ye Jee Shim, Jae Min Lee, Heung Sik Kim, Nani Jung, Young Tak Lim, Eu Jeen Yang, Jeong Ok Hah, Young-Ho Lee, Hee Won Chueh, Jae Young Lim, Eun Sil Park, Jeong A Park, Ji Kyoung Park, Sang Kyu Park
We compared transplant outcomes between donor types and stem cell sources for childhood acute myeloid leukemia (AML). The medical records of children with AML in the Yeungnam region of Korea from January 2000 to June 2017 were reviewed. In all, 76 children with AML (male-to-female ratio = 46:30) received allogenic hematopoietic stem cell transplantation (allo-HSCT). In total, 29 patients received HSCT from either a matched-related donor or a mismatched-related donor, 32 patients received an unrelated donor, and 15 patients received umbilical cord blood...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29921004/small-effort-high-impact-focus-on-physical-activity-improves-oxygen-uptake-vo-2peak-quality-of-life-and-mental-health-after-pediatric-renal-transplantation
#4
Hjørdis Thorsteinsdottir, Trond H Diseth, Anine Lie, Trine Tangeraas, Iren Matthews, Anders Åsberg, Anna Bjerre
This study estimates the effects on peak oxygen uptake (VO2 peak ), QoL, and mental health after the introduction of an adjusted post-transplant follow-up program, that is, early physiotherapy and focus on the importance of physical activity. VO2 peak was measured by a treadmill exercise test in 20 renal-transplanted children on the adjusted post-transplant follow-up and compared with a group of 22 patients investigated in a previously, before the implementation of our new follow-up routines. PedsQL and The Strengths and Difficulties Questionnaire (SDQ) were used to assess QoL and mental health in 45 patients on the new as compared to 32 patients on the previous follow-up strategy...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29920880/effect-of-cyp3a5-1-expression-on-tacrolimus-required-dose-for-transplant-pediatrics-a-systematic-review-and-meta-analysis
#5
REVIEW
Fatemeh Hendijani, Negar Azarpira, Maryam Kaviani
This systematic review was designed to find out optimal tacrolimus dose in pediatrics according to their CYP3A5*1 genotype by performing meta-analysis. PubMed, Scopus, ISI web of Science, ProQuest, Cochrane library, and clinicaltrail.gov were systematically searched to find studies in which tacrolimus dose and/or blood concentration and/or concentration-to-dose (C/D) ratio were determined in genotype groups of CYP3A5*1 in pediatric population. Data were extracted at 14 time points post-transplantation and meta-analysis of mean and SD was performed...
June 19, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29916988/understanding-the-correlation-between-dsa-complement-activation-and-antibody-mediated-rejection-in-heart-transplant-recipients
#6
Qiuheng Zhang, Michelle Hickey, Diana Drogalis-Kim, Ying Zheng, David Gjertson, Martin Cadeiras, Tam Khuu, Arnold S Baas, Eugene C Depasquale, Nancy J Halnon, Gregory Perens, Juan Alejos, Daniel Cruz, Nsair Ali, Richard Shemin, Murray Kwon, Michael C Fishbein, Abbas Ardehali, Mario Deng, Elaine F Reed
BACKGROUND: Donor specific HLA antibodies (DSA) are associated with increased rates of rejection and of graft failure in cardiac transplantation. The goal of this study was to determine the association of preformed and posttransplant development of newly detected DSA (ndDSA) with antibody mediated rejection (AMR) and characterize the clinical relevance of complement activating DSA in heart allograft recipients. METHODS: The study included 128 adult and 48 pediatric heart transplant patients transplanted between 2010 to 2013...
June 18, 2018: Transplantation
https://www.readbyqxmd.com/read/29915589/immunoglobulin-g-fragment-crystallizable-glycosylation-after-hematopoietic-stem-cell-transplantation-is-dissimilar-to-donor-profiles
#7
Noortje de Haan, Maarten J D van Tol, Gertjan J Driessen, Manfred Wuhrer, Arjan C Lankester
Immunoglobulin G (IgG) fragment crystallizable (Fc) N -glycosylation has a large influence on the affinity of the antibody for binding to Fcγ-receptors (FcγRs) and C1q protein, thereby influencing immune effector functions. IgG Fc glycosylation is known to be partly regulated by genetics and partly by stimuli in the microenvironment of the B cell. Following allogeneic hematopoietic stem cell transplantation (HSCT), and in the presence of (almost) complete donor chimerism, IgG is expected to be produced by, and glycosylated in, B cells of donor origin...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29911888/epidemiology-of-clonal-pseudomonas-aeruginosa-infection-in-a-canadian-cystic-fibrosis-population
#8
Maggie A Middleton, Mehdi Layeghifard, Michelle Klingel, Sanja Stanojevic, Yvonne C W Yau, James E A Zlosnik, Adele Coriati, Felix A Ratjen, Elizabeth D Tullis, Anne Stephenson, Pearce Wilcox, Andreas Freitag, Mark Chilvers, Martha McKinney, Annick Lavoie, Pauline W Wang, David S Guttman, Valerie J Waters
RATIONALE: The extent of the genetic relatedness among Pseudomonas aeruginosa isolates and its impact on clinical outcomes in the cystic fibrosis (CF) population is poorly understood. OBJECTIVES: The objectives of this study were to determine the prevalence of clonal P. aeruginosa infection in Canada and to associate P. aeruginosa genotypes with clinical outcomes. METHODS: This was an observational study of adult and pediatric CF patients across Canada...
June 18, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29908231/haploidentical-bone-marrow-transplantation-with-post-transplant-cyclophosphamide-bendamustine-in-pediatric-and-young-adult-patients-with-hematologic-malignancies
#9
Emmanuel Katsanis, Lauren N Sapp, Nicole Varner, Shannon Koza, Baldassarre Stea, Yi Zeng
More than half of patients undergoing hematopoietic cell transplantation at our institution are ethnic or racial minorities, making the search for matched unrelated donors more challenging. Since the introduction of haploidentical bone marrow transplant (haplo-BMT) into our pediatric BMT program in 2015, 69.2% of the recipients have been minorities. Herein, we describe our experience with the first thirteen pediatric and young adult patients with hematologic malignancies who have undergone T-cell replete haplo-BMT following myeloablative conditioning (MAC) at our institution...
June 13, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29908011/pretransplant-increases-in-left-ventricular-volume-and-mass-are-associated-with-qt-prolongation-during-pediatric-liver-transplantation
#10
Hyun-Seok Cho, Wook-Jong Kim, Byungdoo Andrew Lee, Junki Cho, Won-Jung Shin, Gyu-Sam Hwang
Structural alterations in the cirrhotic heart may contribute to electromechanical abnormalities, represented by QT prolongation. The aim of this study was to investigate the changes in QTc according to the operative stage during pediatric LT and to identify which baseline echocardiographic parameters were associated with intraoperative QTc prolongation. Data were evaluated from 39 children undergoing LT for chronic liver disease (median age 9 months). In 19 patients (48.7%), baseline QTc was prolonged ≥440 ms (462 ± 19 ms)...
June 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29907993/comparison-of-histidine-tryptophan-ketoglutarate-and-university-of-wisconsin-preservation-solutions-in-pediatric-liver-transplantation
#11
Richard S Mangus, Joel R Schroering, Taylor J Hathaway, Chandrashekhar A Kubal, Jonathan A Fridell
UW and HTK solutions are the two primary organ preservation solutions most used in the United States. This study analyzes use of the two solutions in all pediatric liver transplants performed at a single center between 2001and 2017. Outcome measures included early graft function, as well as graft and patient survival. Bile duct complications were reviewed. Operative technique, immunosuppressive protocols, and donor acceptance criteria remained uniform among participating surgeons throughout the study period...
June 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29907534/significant-infections-in-liver-transplant-recipients-undergoing-endoscopic-retrograde-cholangiography-are-few-and-unaffected-by-prophylactic-antibiotics
#12
Divyanshoo R Kohli, Tilak U Shah, Doumit S BouHaidar, Ravi Vachhani, M Shadab Siddiqui
INTRODUCTION: Current practice guidelines recommend prophylactic antibiotics prior to endoscopic retrograde cholangiopancreatography (ERCP) in liver transplant recipients (LTR). This study evaluated the risk of clinically significant infections after ERCP in LTR who received antibiotic prophylaxis compared to those who did not. METHODS: This retrospective case-cohort study evaluated all LTR who underwent elective, outpatient ERCP from 2008 to 2015. Hospitalized patients, pediatric allograft recipients and patients with cholangitis or incomplete biliary drainage were excluded...
May 28, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29901555/spectrum-of-pediatric-autoimmune-liver-disease-and-validation-of-its-diagnostic-scores-in-indian-children
#13
Vikrant Sood, Bikrant Bihari Lal, Dinesh Rawat, Rajeev Khanna, Archana Rastogi, Chhagan Bihari, Guresh Kumar, Seema Alam
OBJECTIVES: There is limitedliterature on the spectrum of pediatric autoimmune liver disease (AILD, encompassing both autoimmune hepatitis/AIH and autoimmune sclerosing cholangitis/ASC) in Asian populations and its diagnostic scores similarly require further validation. This work thus aimed to study the clinical characteristics, and to validate available diagnostic criteria in the local pediatric AILD cohort. METHODS: A review of all pediatric AILD cases, presenting over a 6 year (2011-2017) period was done, along with comparison of the available diagnostic scores: original (1999), simplified (2008) score and new proposed (2017) score...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29900673/dynamics-of-virus-specific-t-cell-immunity-in-pediatric-liver-transplant-recipients
#14
R J Arasaratnam, I Tzannou, T Gray, P I Aguayo-Hiraldo, M Kuvalekar, S Naik, A Gaikwad, H Liu, T Miloh, J F Vera, R W Himes, F M Munoz, A M Leen
Immunosuppression following solid organ transplantation (SOT) has a deleterious effect on cellular immunity leading to frequent and prolonged viral infections. To better understand the relationship between post-transplant immunosuppression and circulating virus-specific T cells, we prospectively monitored the frequency and function of T cells directed to a range of latent (CMV, EBV, HHV6, BK) and lytic (AdV) viruses in 16 children undergoing liver transplantation for up to 1 year post-transplant. Following transplant, there was an immediate decline in circulating virus-specific T cells, which recovered post-transplant, coincident with the introduction and subsequent routine tapering of immunosuppression...
June 13, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29900002/hospitalizations-in-dialysis-patients-in-canada-a-national-cohort-study
#15
Amber O Molnar, Louise Moist, Scott Klarenbach, Jean-Philippe Lafrance, S Joseph Kim, Karthik Tennankore, Jeffrey Perl, Joanne Kappel, Michael Terner, Jagbir Gill, Manish M Sood
Background: Hospitalizations of chronic dialysis patients have not been previously studied at a national level in Canada. Understanding the scope and variables associated with hospitalizations will inform measures for improvement. Objective: To describe the risk of all-cause and infection-related hospitalizations in patients on dialysis. Design: Retrospective cohort study using health care administrative databases. Setting: Provinces and territories across Canada (excluding Manitoba and Quebec)...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29899572/hematopoietic-stem-cell-transplantation-for-isolated-extramedullary-relapse-of-acute-lymphoblastic-leukemia-in-children
#16
Maria Gabelli, Marco Zecca, Chiara Messina, Elisa Carraro, Barbara Buldini, Attilio Maria Rovelli, Franca Fagioli, Alice Bertaina, Edoardo Lanino, Claudio Favre, Marco Rabusin, Arcangelo Prete, Mimmo Ripaldi, Walter Barberi, Fulvio Porta, Maurizio Caniglia, Stella Santarone, Paolo D'Angelo, Giuseppe Basso, Franco Locatelli
Relapse of acute lymphoblastic leukemia (ALL) may occur in extramedullary sites, mainly central nervous system (CNS) and testis. Optimal post-remissional treatment for isolated extramedullary relapse (IEMR) is still controversial. We collected data of children treated with hematopoietic stem cell transplantation (HSCT) for ALL IEMR from 1990 to 2015 in Italy. Among 281 patients, 167 had a relapse confined to CNS, 73 to testis, 14 to mediastinum, and 27 to other organs. Ninety-seven patients underwent autologous HSCT, 79 received allogeneic HSCT from a matched family donor, 75 from a matched unrelated donor, and 30 from an HLA-haploidentical donor...
June 13, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29898638/the-experiences-of-young-liver-patients-transferring-from-children-s-to-adult-services-and-their-support-needs-for-a-successful-transition
#17
Alex Toft, Rachel Taylor, Lee Claridge, Charlotte Clowes, James Ferguson, Jonathon Hind, Rebecca Jones, Patricia McClean, Patrick McKiernan, Marianne Samyn, Jane Coad
BACKGROUND: The period of transition from pediatric to adult services represents a time when young people need support, information, and appropriate care in order to successfully move. It is a period that is associated with nonadherence and disengagement with care. OBJECTIVE: To explore the experiences of young liver transplant recipients transitioning to adult services and determine what they require in order to achieve a successful move. The research also explored the possibility of using a mobile phone application (app) as a tool to support transition...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29895662/acute-lymphoblastic-leukemia-in-adolescent-and-young-adults-treat-as-adults-or-as-children
#18
Nicolas Boissel, André Baruchel
Adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) are recognized as a unique population with specific characteristics and needs. In adolescents aged 15-20 years old, the use of full pediatric protocols is supported by many comparative studies of pediatric and adult cooperative groups. In young adults, growing evidence suggests that pediatric-inspired or even fully pediatric approaches may also dramatically improve outcomes, leading to long-term survival rates of almost 70%, despite diminishing indications of hematopoietic stem cell transplantation...
June 12, 2018: Blood
https://www.readbyqxmd.com/read/29894730/utility-of-autopsy-among-pediatric-allogeneic-hematopoietic-stem-cell-transplant-recipients-one-last-chance-to-learn
#19
Matthew S Kelly, Lisa Spees, Richard Vinesett, Andre Stokhuyzen, Lauren McGill, Alan D Proia, Kirsten Jenkins, Mehreen Arshad, Patrick C Seed, Paul L Martin
BACKGROUND: Autopsy may confirm clinical diagnoses or identify conditions that were not suspected prior to a patient's death. Previous studies evaluating the utility of autopsy in hematopoietic stem cell transplant (HSCT) recipients yielded conflicting results. METHODS: We conducted a retrospective cohort study of children (<18 years of age) undergoing allogeneic HSCT at Duke University who died of any cause between January 1, 1995 and December 31, 2016. We evaluated associations between patient characteristics and autopsy performance using Chi-square or Fisher's exact tests...
June 9, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29893957/outcomes-of-human-adenovirus-infection-and-disease-in-a-retrospective-cohort-of-pediatric-hematopoietic-cell-transplant-recipients
#20
Brian T Fisher, Craig L K Boge, Hans Petersen, Alix E Seif, Matthew Bryan, Richard L Hodinka, Ana Maria Cardenas, Dale R Purdy, Brandon Loudon, Adriana E Kajon
Background: Human adenoviruses (HAdVs) are associated with significant morbidity and death after hematopoietic cell transplantation (HCT). In this study, we sought to determine the incidence of HAdV infection among pediatric HCT recipients in the polymerase chain reaction (PCR) testing era, identify risk factors for viremia among patients undergoing HAdV surveillance, and assess the effectiveness of preemptive cidofovir. Methods: A single-center retrospective cohort of patients who underwent a transplant within a 10-year period was assembled...
June 8, 2018: Journal of the Pediatric Infectious Diseases Society
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