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pediatric renal transplant

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https://www.readbyqxmd.com/read/28094348/weight-of-abcb1-and-por-genes-on-oral-tacrolimus-exposure-in-cyp3a5-nonexpressor-pediatric-patients-with-stable-kidney-transplant
#1
G N Almeida-Paulo, I Dapía García, R Lubomirov, A M Borobia, N L Alonso-Sánchez, L Espinosa, A J Carcas-Sansuán
Tacrolimus (TAC) is highly effective for the prevention of acute organ rejection. However, its clinical use may be challenging due to its large interindividual pharmacokinetic variability, which can be partially explained by genetic variations in TAC-metabolizing enzymes and transporters. The aim of this study was to evaluate the influence of genetic and clinical factors on TAC pharmacokinetic variability in 21 stable pediatric renal transplant patients. This study was nested in a previous Prograf to Advagraf conversion clinical trial...
January 17, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28060690/-peritoneal-dialysis-in-the-first-two-years-of-life-experience-of-a-nephrology-and-renal-transplantation-pediatric-unit
#2
Sofia Deuchande, Tânia Mano, Cristina Novais, Rute Machado, Rosário Stone, Margarida Almeida
INTRODUCTION: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purpose was to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life. MATERIAL AND METHODS: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28044426/children-after-renal-transplantation-hospitalized-for-fever-is-empirical-antibiotic-treatment-always-justified
#3
Liat Ashkenazi-Hoffnung, Miriam Davidovits, Efraim Bilavsky, Reem Yassin, Eran Rom, Jacob Amir
Infections are a major cause of morbidity and mortality after renal transplantation. However, data focusing on children are scarce. The objective of this study was to investigate the frequency and predictors of bacterial infection in pediatric renal transplant recipients in a specific setting of hospitalization due to fever. Clinical and laboratory data were retrospectively collected for all pediatric renal transplant recipients hospitalized for fever in a national renal transplantation center from 2004 to 2012...
January 2, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28039534/hypomagnesemia-and-increased-risk-of-new-onset-diabetes-mellitus-after-transplantation-in-pediatric-renal-transplant-recipients
#4
Wesley Hayes, Sheila Boyle, Adrian Carroll, Detlef Bockenhauer, Stephen D Marks
BACKGROUND: New-onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients. METHODS: We undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in this patient population...
December 30, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28030534/single-nucleotide-polymorphism-of-cyp3a5-impacts-the-exposure-to-tacrolimus-in-pediatric-renal-transplant-recipients-a-pharmacogenetic-substudy-of-the-twist-trial
#5
Heiko Billing, Britta Höcker, Alexander Fichtner, Rita van Damme-Lombaerts, Styrbjorn Friman, Jenö Jaray, Karel Vondrak, Eniko Sarvary, Luca Dello Strologo, Michael Oellerich, Nicolas von Ahsen, Burkhard Tönshoff
BACKGROUND: The pharmacokinetics (PK) of tacrolimus (TAC) and mycophenolic acid (MPA) are highly variable. An impact of single-nucleotide polymorphisms (SNPs) of the genes coding for enzymes and transporters involved in the PK of TAC and/or MPA is intuitively conceivable. Accordingly, we sought to analyze the influence of different SNPs on TAC and MPA exposure in pediatric renal transplant recipients. METHODS: A subpopulation of 37 patients (median age: 12.8 years, range 2...
November 24, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28029575/use-of-sirolimus-in-pediatric-heart-transplant-patients-a-multi-institutional-study-from-the-pediatric-heart-transplant-study-group
#6
Joseph W Rossano, John L Jefferies, Elfriede Pahl, David C Naftel, Elizabeth Pruitt, Kathy Lupton, William J Dreyer, Richard Chinnock, Gerard Boyle, William T Mahle
BACKGROUND: Proliferation signal inhibitors, such as sirolimus, are increasingly used in solid-organ transplantation. However, limited data exist on sirolimus-treated pediatric patients. We aimed to describe sirolimus use in pediatric heart transplant patients and test the hypothesis that sirolimus use is associated with improved outcomes. METHODS: A retrospective review and propensity-matched analysis of the Pediatric Heart Transplant Study database was performed on patients undergoing primary heart transplantation from 2004 to 2013 with at least 1 year of follow-up comparing patients treated vs not treated with sirolimus at 1 year after transplant...
October 4, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28019062/complete-resolution-of-trichodysplasia-spinulosa-in-a-pediatric-renal-transplant-patient-case-report-and-literature-review
#7
Lauren P Coogle, Kristen E Holland, Cynthia Pan, Scott K Van Why
TS of immunosuppression is a rare, disfiguring dermatologic condition caused by TS-associated polyomavirus in immunosuppressed patients. It is difficult to treat, with no clearly described approach to resolve the condition completely and safely. We report a child with a renal transplant who developed TS and was treated with significant reduction in immunosuppression and transient use of cidofovir cream. The combined approach, primarily with significant long-term reduction in immunosuppression guided by monitoring BK viremia in our patient, led to complete resolution of TS without recurrence or graft rejection by 5 years after transplant...
December 25, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27995324/hla-epitope-matching-in-pediatric-renal-transplantation
#8
Matthew P Sypek, Peter Hughes, Joshua Y Kausman
Chronic graft loss due to antibody-mediated rejection (AMR) and the difficulty of re-transplanting highly sensitized patients are two of the major long-term challenges in pediatric renal transplantation. Treatments for AMR are often ineffective and desensitization protocols can be a high risk, making prevention a highly appealing strategy. Insights into the structural determinants of humoral alloantigenicity present an exciting opportunity to reassess our current paradigm of tissue matching and potentially preventing these complications...
December 19, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27966317/health-related-quality-of-life-of-pediatric-renal-transplant-recipientsand-their-parents-the-role-of-associated-factors-and-clinical-counseling
#9
Bahar Büyükkaragöz, Necla Buyan, Nahide Doğrucan, Bülent Çelik
BACKGROUND/AIM: This study evaluates the health-related quality of life (HRQoL) of pediatric renal transplant recipients and their parents and investigates the effects of clinical, socioeconomic, and psychological factors as well as continuous counseling on the HRQoL. MATERIALS AND METHODS: Patients aged 8-17 years (mean: 14.9 ± 2.9) were enrolled. Clinical and demographic data were noted. The Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), and Turkish version of the Kinder Lebensqualität Fragebogen (KINDL) questionnaire for children and the BDI, RSES, parent-proxy version of KINDL, and Short-Form 36 (SF-36) for parents were applied (step 1)...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27966039/magnetic-resonance-tissue-phase-mapping-demonstrates-altered-left-ventricular-diastolic-function-in-children-with-chronic-kidney-disease
#10
Charlotte Gimpel, Bernd A Jung, Sabine Jung, Johannes Brado, Daniel Schwendinger, Barbara Burkhardt, Martin Pohl, Katja E Odening, Julia Geiger, Raoul Arnold
BACKGROUND: Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease. OBJECTIVE: To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease. MATERIALS AND METHODS: Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle...
December 13, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27941974/cost-evaluation-of-dried-blood-spot-home-sampling-as-compared-to-conventional-sampling-for-therapeutic-drug-monitoring-in-children
#11
Lisa C Martial, Rob E Aarnoutse, Michiel F Schreuder, Stefanie S Henriet, Roger J M Brüggemann, Manuela A Joore
Dried blood spot (DBS) sampling for the purpose of therapeutic drug monitoring can be an attractive alternative for conventional blood sampling, especially in children. This study aimed to compare all costs involved in conventional sampling versus DBS home sampling in two pediatric populations: renal transplant patients and hemato-oncology patients. Total costs were computed from a societal perspective by adding up healthcare cost, patient related costs and costs related to loss of productivity of the caregiver...
2016: PloS One
https://www.readbyqxmd.com/read/27938596/-focal-segmental-glomerulosclerosis-after-renal-transplantation-in-a-child-with-anca-associated-glomerulonephritis-case-report-and-literature-review
#12
L P Rong, L Z Chen, Q Fu, W F Chen, L Z Sun, X Y Jiang, Y Mo
Objective: To study the clinical features and treatment of focal segmental glomerulosclerosis (FSGS) after renal transplantation in a child with ANCA-associated glomerulonephritis. Method: The clinical and pathological data of the patient treated in the Department of Pediatrics as well as in the Department of Organ Transplantation in November 2015 in the First Affiliated Hospital of Sun Yat-sen University, who was diagnosed with de novo FSGS after renal transplantation with a primary disease ANCA-associated glomerulonephritis, was analyzed retrospectively...
December 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27932116/surgical-complications-in-en-bloc-renal-transplantation
#13
M A Moreno de la Higuera Díaz, N Calvo Romero, I Pérez-Flores, M Calvo Arévalo, B Rodríguez Cubillo, A Shabaka, V López de la Manzanara, Á Gómez Vegas, J Blázquez Izquierdo, A I Sánchez-Fructuoso
En bloc pediatric transplantation (EBPT) began with the aim of increasing the donor pool due to the existing high demand for donors. At its inception, it was considered a type of suboptimal transplantation due to its association with a high incidence of vascular, urologic, and immunologic complications. The main objective of this study was to update information on EBPT with the largest case series that exists on a worldwide scale. In a retrospective study, the results obtained from brain-dead donors (BDDs; n = 770) were compared to those of EBPT (n = 100) from January 1990 to December 2012...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27894119/trajectories-and-predictors-of-allograft-dysfunction-after-renal-transplantation-in-children
#14
Vandréa Carla de Souza, Muriel Rabilloud, Pierre Cochat, Mario Bernardes Wagner, Clotilde Druck Garcia, Bruno Ranchin, Jean Iwaz, Luciano Selistre, Laurence Dubourg
BACKGROUND: The survival rates of renal transplant children are indeed on the rise, but it is still important to ensure that there is optimal renal function in these children in all their future growing years. The number of functioning nephrons and the graft ability to adapt to an increasing demand during body growth seem to be the most important factors for long-term allograft function. This study examined the long-term change in the glomerular filtration rate in a pediatric kidney transplant cohort and the importance of the recipient and donor ages in predicting transplant outcome...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/27865440/hemoglobin-of-12-g-dl-and-above-is-not-associated%C3%A2-with-increased-cardiovascular-morbidity%C3%A2-in-children-on-hemodialysis
#15
Michelle N Rheault, Julia T Molony, Thomas Nevins, Charles A Herzog, Blanche M Chavers
In adults on chronic hemodialysis, achieving a hemoglobin concentration of 12g/dl and above with erythropoiesis stimulating agents leads to increased cardiovascular events and mortality, but this may not be true in children. Therefore, we conducted a retrospective cohort study of pediatric patients (under 18) from the Centers for Medicare and Medicaid Services End Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) project (2000 to 2008) merged with the United States Renal Data System. Hemoglobin was determined from the Clinical Performance Measures data, and beginning annually on January 1st of the next year, patients were followed for up to 1 year...
January 2017: Kidney International
https://www.readbyqxmd.com/read/27855273/ureteroureterostomy-an-alternative-to-ureteroneocystostomy-in-select-cases-of-pediatric-renal-transplantation
#16
Frank J Penna, Armando J Lorenzo, Walid A Farhat, Hissan Butt, Martin A Koyle
PURPOSE: Ureteroneocystostomy is the standard mode of establishing urinary drainage in renal transplantation. However, donor-to-recipient ureteroureterostomy may be considered in the presence of a challenging bladder or an augmented bladder, or when the donor ureter might be compromised or is too short. This approach also preserves a nonrefluxing system with an orthotopic ureteral orifice. MATERIALS AND METHODS: We retrospectively reviewed the records of all pediatric renal transplantations in which ureteroureterostomy was performed at a single tertiary care pediatric center over the 12-year period from 2004 to 2015...
November 14, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27805518/timing-for-removal-of-peritoneal-dialysis-catheters-in-pediatric-renal-transplant-patients
#17
Engin Melek, Esra Baskın, Kaan Savaş Gülleroğlu, Mahir Kırnap, Gökhan Moray, Mehmet Haberal
OBJECTIVES: Peritoneal dialysis, the preferred long-term renal replacement modality in the pediatric population, can also be used during the post transplant period. Although it is well known that peritonitis or other complications may occur related to the peritoneal dialysis catheter, less is known about complications related to the peritoneal dialysis during the posttransplant period. Our objective was to evaluate the complications related to use of a peritoneal dialysis catheter during the posttransplant period and to determine the optimum time for removal of the peritoneal dialysis catheter...
2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#18
Mohamed Adel Bakr, Ahmed Abdelfattah Denewar, Mohamed Hamed Abbas
Despite many achievements in renal transplant in the past few years regarding immunosuppression and tissue matching, the rates of early and late graft loss and return to dialysis are still high. Many of those with primary graft failure will be listed for a kidney retransplant, as this allows for better quality of life than dialysis. Many challenges face those requiring renal retransplant, including first graft nephrectomy and whether site of retransplant should be ipsilateral or contralateral, whether to conduct preemptive retransplant or wait while on dialysis, additional immunologic factors, immunosuppression after retransplant, cancer risk, BK virus infection, and retransplant in pediatrics...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27793653/urologic-outcomes-of-children-with-hemorrhagic-cystitis-after-bone-marrow-transplant-at-a-single-institution
#19
Jason K Au, Christopher Graziano, Rodolfo A Elizondo, Sheila Ryan, David R Roth, Chester J Koh, Edmond T Gonzales, Duong T Tu, Nicolette Janzen, Swati Naik, Abhishek Seth
OBJECTIVE: To analyze clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with hemorrhagic cystitis (HC) after bone marrow transplant (BMT). METHODS: A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008 to 2015 was conducted. Demographic data, severity of hematuria, HC management, and mortality were analyzed. Bivariate analysis and binary logistic regression were performed to identify risk factors...
October 25, 2016: Urology
https://www.readbyqxmd.com/read/27781344/endoscopic-antireflux-surgery-leading-to-obstruction-in-pediatric-renal-transplant-patients
#20
Gina Cambareri, Christina Carpenter, Jeffrey Stock, Jane Lewis, Sarah Marietti
To describe a multicenter experience with management of ureteral obstruction after injection of Dx/HA for VUR in pediatric renal transplant patients. The records of all pediatric renal transplant patients who underwent Dx/HA injection for VUR and had subsequent obstruction were identified, and the management and outcomes were reviewed. Follow-up ranged from 1 to 10 years. There were four patients identified, all of whom had a history of rising creatinine, recurrent UTI, and increasing hydronephrosis which led to the diagnosis of high-grade VUR...
October 26, 2016: Pediatric Transplantation
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