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pediatric renal transplant

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https://www.readbyqxmd.com/read/27894119/trajectories-and-predictors-of-allograft-dysfunction-after-renal-transplantation-in-children
#1
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...
November 29, 2016: American Journal of Nephrology
https://www.readbyqxmd.com/read/27865440/hemoglobin-of-12-g-dl-and-above-is-not-associated-with-increased-cardiovascular-morbidity-in-children-on-hemodialysis
#2
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...
November 16, 2016: Kidney International
https://www.readbyqxmd.com/read/27855273/ureteroureterostomy-an-alternative-to-ureteroneocystostomy-in-select-cases-of-pediatric-renal-transplantation
#3
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
#4
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...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#5
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
#6
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 analyzed clinical outcomes and the risk factors associated with genitourinary (GU) morbidity and mortality in children who present with Hemorrhagic Cystitis (HC) after bone marrow transplantation (BMT). METHODS: A retrospective chart review of patients with HC who had undergone BMT at a single pediatric hospital from 2008-2015 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
#7
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
https://www.readbyqxmd.com/read/27762478/bk-polyomavirus-infection-in-pediatric-heart-transplant-recipients-a-prospective-study
#8
Allison Ducharme-Smith, Ben Z Katz, Amy E Bobrowski, Carl L Backer, Elfriede Pahl
BKV infection and nephropathy complicate pediatric HTx, but the incidence and time course of the disease are unknown. We assessed the incidence of BKV infection and its association with kidney dysfunction in pediatric HTx recipients. A single center prospective study compared pediatric (<18 years) HTx recipients, with and without BKV infection, who received an allograft between September 2013 and December 2014. Screening of urine for BKV was performed prior to transplant, and at week 1, and at months 3, 6, 9, 12, and 15 months post-transplantation...
October 20, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27753183/tolerability-of-up-to-200%C3%A2-days-of-prophylaxis-with-valganciclovir-oral-solution-and-or-film-coated-tablets-in-pediatric-kidney-transplant-recipients-at-risk-of-cytomegalovirus-disease
#9
G Varela-Fascinetto, C Benchimol, R Reyes-Acevedo, M Genevray, D Bradley, J Ives, H T Silva
This multicenter, open-label study evaluated the tolerability of extended prophylaxis with valganciclovir in pediatric kidney transplant recipients at risk of CMV disease. Fifty-six patients aged 4 months to 16 years received once-daily valganciclovir oral solution and/or tablets, dosed by BSA and renal function, for up to 200 days. The most common AEs on treatment were upper respiratory tract infection (33.9%), urinary tract infection (33.9%), diarrhea (32.1%), leukopenia (25.0%), neutropenia (23.2%), and headache (21...
October 17, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27737391/development-of-height-and-body-mass-index-after-pediatric-kidney-transplantation-experience-of-the-nephrology-pediatric-service-at-hcfmrp-usp-2005-2014
#10
Elaine Hillesheim, Valéria Laguna Salomão Ambrósio, Inalda Facincani
Introduction: Chronic kidney disease in children often determines poor nutritional status. Although renal transplantation (RTx) resolves endocrine and metabolic disorders, growth continues to be suboptimal and excessive weight gain may result in obesity. Objectives: Evaluating the development of height and body mass index in renal transplanted children and adolescents and identifying associated factors with final nutritional status. Methods: We reviewed the medical records of 17 patients with regular follow-ups up to 24 months after RTx...
July 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27736823/corticosteroid-use-and-growth-after-pediatric-solid-organ-transplantation-a-systematic-review-and-meta-analysis
#11
Anne Tsampalieros, Greg A Knoll, Amber O Molnar, Nicholas Fergusson, Dean A Fergusson
BACKGROUND: A number of corticosteroid minimization and avoidance protocols for post-solid organ transplant have been developed. The study objective was to examine the effect of corticosteroid withdrawal/avoidance on growth and safety parameters in pediatric solid organ transplant recipients. METHODS: A systematic review using Medline and Embase was performed. All randomized controlled trials (RCT) and observational studies comparing corticosteroid withdrawal/avoidance to controls receiving corticosteroids in pediatric transplant recipients which reported growth as change in height or final height were included...
July 12, 2016: Transplantation
https://www.readbyqxmd.com/read/27732587/pediatric-kidney-transplantation-a-historical-review
#12
REVIEW
Priya S Verghese
Successful renal transplantation is the optimal treatment for chronic kidney failure, but this was not always so for children. Beginning with the first kidney transplants in the 1950s, children experienced poorer patient and graft survival rates than adult patients. But over the last 6 decades, an improved understanding of the immune system which has steered pediatric multi-center clinical/pharmacokinetic and mechanistic studies that have sculpted our immunosuppression with markedly better patient and graft survivals...
November 16, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27712016/post-transplant-blood-transfusions-and-pediatric-renal-allograft-outcomes
#13
Priya Verghese, Kristen Gillingham, Arthur Matas, Srinath Chinnakotla, Blanche Chavers
The association of blood transfusions with GS after pediatric KTx is unclear. We retrospectively analyzed blood transfusions post-KTx and subsequent outcomes. Between 1984 and 2013, 482 children (<18 years of age) underwent KTx at our center. Recipient demographics, outcomes and transfusion data were collected. Cox regression with post-KTx blood transfusion as a time-dependent covariate was performed to model the impact of blood transfusion on outcomes. Of the 208 (44%) that were transfused, 39% had transfusion <1 month post-KTx; 48% >12 months...
November 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27696583/yield-and-complications-of-kidney-biopsies-over-two-decades-in-a-tertiary-pediatric-center
#14
Roei Hod Feins, Anna Tobar, Miriam Davidovits
BACKGROUND: Kidney biopsy serves as an adjunct for the diagnosis of renal disease. However, it is not always productive. This study evaluated the yield and risks of kidney biopsies performed in 1995-2014 at a tertiary pediatric medical center. METHODS: The medical files of all patients who underwent closed percutaneous biopsy for various indications in native or transplanted kidneys were retrospectively reviewed for patient characteristics, technical and histopathologic findings, biopsy yield, and biopsy complications...
October 3, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27695033/an-empirical-biomarker-based-calculator-for-cystic-index-in-a-model-of-autosomal-recessive-polycystic-kidney-disease-the-nieto-narayan-formula
#15
Jake A Nieto, Michael A Yamin, Itzhak D Goldberg, Prakash Narayan
Autosomal recessive polycystic kidney disease (ARPKD) is associated with progressive enlargement of the kidneys fuelled by the formation and expansion of fluid-filled cysts. The disease is congenital and children that do not succumb to it during the neonatal period will, by age 10 years, more often than not, require nephrectomy+renal replacement therapy for management of both pain and renal insufficiency. Since increasing cystic index (CI; percent of kidney occupied by cysts) drives both renal expansion and organ dysfunction, management of these patients, including decisions such as elective nephrectomy and prioritization on the transplant waitlist, could clearly benefit from serial determination of CI...
2016: PloS One
https://www.readbyqxmd.com/read/27693278/-pediatric-kidney-transplantation
#16
L Badet, X Matillon, R Codas, M-O Timsit, R Thuret, F Kleinclauss, D Demede
AIMS: To describe indications, surgical aspects, results and outcomes of kidney transplantation in children. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): "kidney transplantation", "pediatric", "children", "outcomes". Publications obtained were selected based on methodology, language, date of publication (last 10 years) and relevance...
September 29, 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27683424/risk-factors-for-graft-loss-in-pediatric-renal-transplant-recipients-after-transfer-of-care
#17
Bethany Coyne, Patricia J Hollen, Guofen Yan, Kenneth Brayman
BACKGROUND: Improvements in transplantation have increased the survival of children after kidney transplantation. These patients have complex needs, and the current medical system is not prepared to effectively transfer the care of these individuals from pediatric to adult health-care systems. Too often, transfer occurs during moments of crisis and is associated with poor outcomes. OBJECTIVE: The aim of this study was to use a national database, the Scientific Registry of Transplant Recipients, to test the hypothesis that the increased risk of graft loss after transfer of care (from pediatric to adult services) for young adult kidney transplant recipients over a 2- to 3-year posttransfer follow-up period was related to these posttransfer risk factors (medication noncompliance, acute rejection, insurance status)...
September 28, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27677979/clinical-presentation-and-outcome-of-pediatric-anca-associated-glomerulonephritis
#18
Anne M Kouri, Sharon P Andreoli
BACKGROUND: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a small- and medium-sized vasculitis classically seen in adult patients, with peak onset near the fifth to seventh decade of life. There is little data on ANCA-associated vasculitis in pediatric patients, and most studies have limited follow-up. METHODS: This is a retrospective chart review of 22 patients with ANCA-positive glomerulonephritis in a single institution from 1991 to 2013...
September 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27677977/quality-of-life-in-children-with-chronic-kidney-disease
#19
John Dotis, Antigoni Pavlaki, Nikoleta Printza, Stella Stabouli, Stamatia Antoniou, Chrysa Gkogka, Nikolaos Kontodimopoulos, Fotios Papachristou
BACKGROUND: Progressive chronic kidney disease (CKD), irrespective of the underlying etiology, affects the quality of life (QoL) of children due to the need for regular follow-up visits, a strict medication program and diet intake. METHODS: The Greek version of the KIDSCREEN-52 multidimensional questionnaire was used in children with CKD, renal transplantation (RT) and in a control group (CG) of healthy children. RESULTS: Fifty-five patients between 8 and 18 years, with CKD (n = 25), RT (n = 16) and with end-stage renal disease (ESRD) on peritoneal dialysis (PD) (n = 14) were included...
September 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27677732/clinical-pharmacokinetics-of-mycophenolic-acid-in-hematopoietic-stem-cell-transplantation-recipients
#20
Daping Zhang, Diana S-L Chow
Mycophenolate mofetil (MMF), an ester prodrug of mycophenolic acid (MPA), is widely used as a maintenance immunosuppressive regimen in solid organ transplant patients. It is increasingly used for the prophylaxis and treatment of graft-versus-host disease (GVHD) in hematopoietic stem cell transplantation (HSCT) patients. MPA displays extensive binding to serum albumin and glucuronidation to the inactive MPA-7-O-glucuronide (MPAG). Here, we review and discuss the pertinent information regarding the clinical pharmacokinetics of MPA in HSCT patients...
September 27, 2016: European Journal of Drug Metabolism and Pharmacokinetics
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