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Pediatric Transplant

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https://www.readbyqxmd.com/read/29691808/total-body-irradiation-for-hematopoietic-stem-cell-transplantation-during-early-childhood-is-associated-with-the-risk-for-diabetes-mellitus
#1
Ryuichi Nakagawa, Atsumi Hosokawa-Tsuji, Yuki Aoki, Kei Takasawa, Mitsue Maru, Keisuke Nakajima, Akito Sutani, Yuichi Miyakawa, Daisuke Tomizawa, Kenichi Kashimada, Tomohiro Morio
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a curative treatment for life-threatening malignancies and related diseases. Recently, the long-term prognosis of HSCT during childhood has greatly improved; however, the late adverse effects of HSCT have been found to cause substantial morbidity among long-term survivors. Although metabolic complications, such as diabetes mellitus (DM) and hyperlipidemia (HL), are the major late effects of pediatric HSCT, the clinical details are not clarified sufficiently...
April 24, 2018: Endocrine
https://www.readbyqxmd.com/read/29690960/is-hepatovenocaval-syndrome-a-different-entity-from-budd-chiari-syndrome-in-children
#2
Nadia Waheed, Huma Arshad Cheema, Hassan Suleman, Iqra Mushtaq, Zafar Fayyaz, Nadeem Anjum
OBJECTIVE: To differentiate between clinical and demographic spectrum, and outcome in hepatovenocaval syndrome (HVCS) and Budd-Chiari syndrome (BCS). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children Hospital, Lahore, from January 2014 to January 2017. METHODOLOGY: All children less than 18 years of age, presenting with ascites and visible veins over abdomen, flanks and back were enrolled in the study...
May 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29684375/cumulative-effect-of-preoperative-risk-factors-on-mortality-after-pediatric-heart-transplantation
#3
Matthew J O'Connor, Andrew C Glatz, Joseph W Rossano, Robert E Shaddy, Rachel Ryan, Chitra Ravishankar, Stephanie Fuller, Christopher E Mascio, J William Gaynor, Kimberly Y Lin
BACKGROUND: Risk assessment in heart transplantation is critical for candidate selection, but current models inadequately assess individual risk of postoperative mortality. We sought to identify risk factors and develop a scoring system to predict mortality following heart transplantation in children. METHODS: The records of patients undergoing heart transplantation at our institution from 2010 - 2016 were reviewed. Clinical characteristics were recorded and compared between survivors and non-survivors...
April 20, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29684000/split-liver-transplantation-and-pediatric-waitlist-mortality-in-the-united-states-potential-for-improvement
#4
Emily R Perito, Garrett Roll, Jennifer L Dodge, Sue Rhee, John P Roberts
BACKGROUND: In the United States, 1 in 10 infants and 1 in 20 older children die on the liver transplant waiting list. Increasing split liver transplantation could increase organ availability for these children, without decreasing transplants in adults. METHODS: Using UNOS STAR data, we identified livers transplanted 2010-2015 that could potentially have been used for split transplant, based on strict criteria. Livers not suitable for pediatric patients or allocated to high-risk recipients were excluded...
April 21, 2018: Transplantation
https://www.readbyqxmd.com/read/29683122/symptoms-and-self-management-strategies-identified-by-children-with-cancer-using-draw-and-tell-interviews
#5
Lauri A Linder, Heather Bratton, Anna Nguyen, Kori Parker, Sarah E Wawrzynski
PURPOSE: This cross-sectional study described how school-aged children with cancer represent their symptoms and associated characteristics using draw-and-tell interviews. PARTICIPANTS & SETTING: 27 children aged 6-12 years receiving treatment for cancer at the Cancer Transplant Center at Primary Children's Hospital, a tertiary pediatric hospital in Salt Lake City, Utah. METHODOLOGIC APPROACH: Children participated in draw-and-tell interviews while completing drawings depicting days when they felt well and days when they felt sick...
May 1, 2018: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29682835/longitudinal-examination-of-family-efficacy-following-pediatric-stem-cell-transplant
#6
Rachel Tillery, Naomi E Joffe, Constance A Mara, Stella M Davies, Ahna L H Pai
OBJECTIVE: Pediatric stem cell transplant (pSCT) is emotionally demanding for families. Yet, we know little of how the family unit responds to the adversity of pSCT within the first year after transplant. Family efficacy, an indicator of family resilience, is linked to positive parent, child, and family adjustment. Better understanding the factors that promote family efficacy during this difficult time could inform modifiable intervention targets and improve child and parent adjustment...
April 23, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29679436/fungal-infections-in-hematopoietic-stem-cell-transplantation-in-children-at-a-pediatric-children-s-hospital-in-argentina
#7
Sergio Miguel Gomez, Miguela Caniza, Alicira Fynn, Cecilia Vescina, Claudia Ruiz, Daniela Iglesias, Fernanda Sosa, Lillian Sung
Our primary objective was to describe the incidence of proven or probable invasive fungal infections (IFIs), a devastating complication of hematopoietic stem cell transplant (HSCT), in HCST in a middle-income country. Secondary objectives were to describe factors associated with IFIs and outcomes. In this single center retrospective study, pediatric patients who underwent a first allogeneic or autologous HSCT from 1998 to 2016 were included. Of the 251 HSCT recipients: 143 transplants were allogeneic and 108 were autologous...
April 20, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29677384/risk-factors-and-long-term-outcomes-of-pediatric-liver-transplant-recipients-with-chronic-high-epstein-barr-virus-loads
#8
Hideya Kamei, Yoshinori Ito, Junichi Kawada, Satoshi Ogiso, Yasuharu Onishi, Masahiko Komagome, Nobuhiko Kurata, Yasuhiro Ogura
BACKGROUND: Serial monitoring of Epstein-Barr virus (EBV) reveals that certain pediatric liver transplant (LT) recipients exhibit high EBV loads for long periods. We investigated the incidence and risk factors of chronic high EBV (CHEBV) loads (continuous EBV DNA >10000 IU/mL of whole blood for ≥6 months) and long-term outcomes. METHODS: This single center, retrospective observational study investigated pediatric LT recipients who survived ≥6 months. We quantitated EBV DNA weekly during hospitalization and subsequently every 4 or 6 weeks at the outpatient clinic...
April 20, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29677081/changes-in-pediatric-heart-transplant-hospitalization-costs-over-time
#9
Justin Godown, Cary Thurm, Matt Hall, Jonathan H Soslow, Brian Feingold, Bret A Mettler, Andrew H Smith, David W Bearl, Debra A Dodd
BACKGROUND: Despite significant changes in the past decade for children undergoing heart-transplantation, including the evolution of mechanical circulatory support and increasing patient complexity, costs and resource utilization have not been reassessed. We sought to utilize a novel linkage of clinical-registry and administrative data to examine changes in hospitalization costs over time in this population. METHODS: We identified all pediatric heart transplant recipients in a unique linked PHIS/SRTR dataset (2002-2016)...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29676701/single-center-long-term-results-of-pediatric-liver-transplantation
#10
Mohammad Hussein Al Sayyed, Alireza Shamsaeefar, Saman Nikeghbalian, Seyyed Mohsen Dehghani, Ali Bahador, Masood Dehghani, Razieh Rasekh, Siavash Gholami, Bahareh Khosravi, Seyyed Ali Malek Hosseini
OBJECTIVES: Liver replacement continues to be the only definitive mode of therapy for children with end-stage liver disease. However, it remains challenging because of the rare donor organs, complex surgical demands, and the necessity to prevent long-term complications. Our objectives were to analyze 16 years of experience in the Shiraz University Organ Transplant Center. MATERIALS AND METHODS: We retrospectively analyzed the records of 752 patients (< 18 years old) who underwent orthotopic liver transplant at our center over a 16-year period...
April 20, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29673096/impact-of-graft-thickness-reduction-of-left-lateral-segment-on-outcomes-following-pediatric-living-donor-liver-transplantation
#11
Toshihiro Kitajima, Seisuke Sakamoto, Kengo Sasaki, Soichi Narumoto, Kourosh Kazemi, Yoshihiro Hirata, Akinari Fukuda, Rumi Imai, Osamu Miyazaki, Rie Irie, Satoshi Teramukai, Shinji Uemoto, Mureo Kasahara
Reducing graft thickness is essential to prevent large-for-size graft problems in pediatric living donor liver transplantation (LDLT). However, long-term outcomes of LDLT using reduced-thickness left lateral segment (LLS) grafts are unclear. In 89 patients who underwent LDLT using reduced LLS grafts between 2005 and 2017, short-term and long-term outcomes were compared between a non-anatomically reduced LLS (NAR-LLS) graft group and a reduced-thickness LLS graft group. Estimated blood loss was lower and abdominal skin closure was less needed in the recipient operation in the reduced-thickness LLS graft group...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29673058/pediatric-heart-transplantation-across-a-positive-crossmatch-first-year-results-from-the-ctotc-04-multi-institutional-study
#12
S Webber, A Zeevi, K Mason, L Addonizio, E Blume, A Dipchand, R Shaddy, B Feingold, C Canter, D Hsu, W Mahle, B Armstrong, Y Morrison, D Ikle, H Diop, J Odim
Sensitization is common in pediatric heart transplant candidates and wait list mortality is high. Transplantation across a positive crossmatch may reduce wait time, but is considered high risk. We prospectively recruited consecutive candidates at 8 North American centers. At transplantation, subjects were categorized as non-sensitized or sensitized (presence of ≥1 HLA antibody with MFI ≥1,000 using single antigen beads). Sensitized subjects were further classified as CDC-crossmatch positive or negative and as DSA positive or negative...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29671081/type-2-diabetes-mellitus-the-metabolic-syndrome-and-its-components-in-adult-survivors-of-acute-lymphoblastic-leukemia-and-hematopoietic-stem-cell-transplantations
#13
REVIEW
Bella Bielorai, Orit Pinhas-Hamiel
PURPOSE OF REVIEW: A growing number of pediatric acute lymphoblastic leukemia (ALL) and hematopoietic stem cell transplantation (HSCT) survivors reach adulthood and face long-term health-related problems. We review risk factors and the prevalence of the metabolic syndrome (MetS), a cluster of obesity-related comorbidities, including abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, impaired glucose metabolism, and type 2 diabetes in ALL and HSCT survivors. RECENT FINDINGS: Components of the MetS are already detected during the first year of ALL maintenance therapy and significantly worsen over time...
April 18, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29671067/vaccinations-in-pediatric-kidney-transplant-recipients
#14
REVIEW
Thomas G Fox, Corina Nailescu
Pediatric kidney transplant (KT) candidates should be fully immunized according to routine childhood schedules using age-appropriate guidelines. Unfortunately, vaccination rates in KT candidates remain suboptimal. With the exception of influenza vaccine, vaccination after transplantation should be delayed 3-6 months to maximize immunogenicity. While most vaccinations in the KT recipient are administered by primary care physicians, there are specific schedule alterations in the cases of influenza, hepatitis B, pneumococcal, and meningococcal vaccinations; consequently, these vaccines are usually administered by transplant physicians...
April 18, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29669691/resistance-index-of-hepatic-artery-can-predict-anastomotic-biliary-complications-after-liver-transplantation-in-children
#15
Fang-Min Liao, Mei-Hwei Chang, Ming-Chih Ho, Huey-Ling Chen, Yen-Hsuan Ni, Hong-Yuan Hsu, Jia-Feng Wu
BACKGROUND/PURPOSE: Biliary complications remain a major morbidity after liver transplantation in children. Inadequate arterial supply to the bile duct after transplantation plays an important role in developing anastomotic biliary complications. We aimed to elucidate the relationship between the resistance index (RI) of hepatic artery and the anastomotic biliary complications after liver transplantation in children. METHODS: This is a retrospective, case-control design study...
April 16, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29669347/combined-pancreatic-islet-lung-liver-transplantation-in-a-pediatric-patient-with-cystic-fibrosis-related-diabetes
#16
Philippe Klee, Mirjam Dirlewanger, Vanessa Lavallard, Valerie A McLin, Anne Mornand, Nadine Pernin, Laetitia-Marie Petit, Paola M Soccal, Barbara E Wildhaber, Urs Zumsteg, Jean-Louis Blouin, Thierry Berney, Valerie M Schwitzgebel
BACKGROUND: Cystic fibrosis-related diabetes (CFRD) is the most frequent extrapulmonary complication of cystic fibrosis (CF). METHODS: We report the first combined pancreatic islet-lung-liver transplantation in a 14-year-old adolescent. CFTR was analyzed by Sanger sequencing. Further genes were analyzed by high-throughput sequencing. RESULTS: The patient was diagnosed with CF at the age of 14 months. Nine years later, after diagnosis of CFRD, the patient's BMI and lung function began to decline...
April 18, 2018: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/29668078/adherence-and-immune-response-to-revaccination-following-hematopoietic-stem-cell-transplantation-at-a-pediatric-onco-hematology-reference-center
#17
Fernanda Gouveia-Alves, Roseane Gouveia, Valéria C Ginani, Adriana Seber, Danielle A Kuramoto, Gabriel F A Murad, Fernanda G Spina, Antonio S Petrilli, Victor G Zecchin, Celso Granato, Fabianne Carlesse, M Isabel de Moraes-Pinto
BACKGROUND: Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatric and young adult patients. METHODS: Patients submitted to HSCT for over 3 years were recruited. After written informed consent, a questionnaire was filled in, the vaccination card was analyzed, a blood sample was collected and tested by ELISA for diphtheria, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, tetanus, measles, rubella and varicella antibodies...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29668027/heart-transplant-in-children-what-a-primary-care-provider-needs-to-know
#18
Swati Sehgal, Emily Shea, Lauren Kelm, Deepak Kamat
Heart transplantation is offered to children with heart failure that is not amenable to medical or surgical therapy. Indications for heart transplant include unrepairable congenital heart disease, failed palliation of congenital heart disease, and cardiomyopathies. There has been tremendous progress in this field since the first heart transplant was performed in 1967. Each year, approximately 500 pediatric heart transplants take place worldwide. Pediatric heart transplant survivors are living longer with their initial transplant...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29667720/mycophenolate-mofetil-administered-every-8-hours-in-combination-with-tacrolimus-is-efficacious-in-the-prophylaxis-of-acute-graft-versus-host-disease-in-childhood-adolescent-and-young-adult-allogeneic-stem-cell-transplantation-recipients
#19
Olga Militano, Mehmet F Ozkaynak, Brinda Mehta, Carmella van deVen, Carl Hamby, Mitchell S Cairo
BACKGROUND: The optimal dose and schedule of mycophenolate mofetil (MMF) in pediatric allogeneic stem cell transplant recipients remains to be determined. We previously reported safety and pharmacokinetics of MMF at 900 mg/m2 q6h dosing. This study was conducted to investigate the efficacy of tacrolimus plus q8h MMF dosing for acute graft versus host disease (GVHD) prophylaxis in a heterogeneous population of children, adolescent, young adult allogeneic stem cell transplant recipients, utilizing multiple allogeneic donor sources...
April 18, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29667250/a-new-2d-echocardiographic-approach-to-evaluate-the-membrane-and-valve-movement-of-the-berlin-heart-excor-vad-chamber-in-pediatric-vad-patients
#20
Arianna Di Molfetta, Roberta Iacobelli, Gianfranco Ferrari, Sergio Filippelli, Gianluigi Perri, Alessandra Toscano, Rachele Adorisio, Paolo Guccione, Antonio Amodeo
The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and its interaction with the native heart in a pediatric population. ECHO evaluation of BH membrane movement, and inflow and outflow valves was performed in 2D, 2D-color Doppler, M-mode, and M-mode color Doppler to assess the functioning of the device by direct positioning of the ECHO probe on the BH cannulas and membranes...
April 2018: Artificial Organs
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