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https://www.readbyqxmd.com/read/29792975/bladder-agenesis-and-associated-pelvic-arterial-anomaly-in-two-female-pediatric-patients
#1
Thomas Lowrey, Shellie Josephs, Linda A Baker
Bladder agenesis is an extremely rare congenital anomaly of the genitourinary tract. Two female patients with known diagnoses of bladder agenesis presented for pre-renal transplant evaluation and neobladder creation. Similar unique pelvic arterial malformations were identified through pre-operative imaging and intraoperative examination. With these similar findings, it could be proposed that such anatomical variants are products of the same insult or involve a causal relationship, with vascular aberrancies potentially provoking pelvic organ maldevelopment...
May 21, 2018: Urology
https://www.readbyqxmd.com/read/29781948/outcomes-of-pediatric-abo-incompatible-living-kidney-transplantations-from-2002-to-2015-an-analysis-of-the-japanese-kidney-transplant-registry
#2
Motoshi Hattori, Makiko Mieno, Seiichiro Shishido, Atsushi Aikawa, Hidetaka Ushigome, Shinichi Ohshima, Kota Takahashi, Akira Hasegawa
BACKGROUND: Extensive data have been accumulated for adults who have undergone ABO-incompatible (ABOi)-living kidney transplantation (LKT). In contrast, available published data on pediatric recipients who underwent ABOi-LKT from the early to middle 2000s is very limited. Thus, pediatric ABOi-LKT has remained relatively rare and there is a lack of large, multicenter data. METHODS: We analyzed data from the Japanese Kidney Transplant Registry to clarify the patient and graft outcomes of pediatric recipients who underwent ABOi-LKT from 2002 to 2015...
April 30, 2018: Transplantation
https://www.readbyqxmd.com/read/29767471/converting-immunosuppression-from-an-oral-suspension-to-a-granule-formulation-of-tacrolimus-in-pediatric-renal-transplant-recipients
#3
Georgia Malakasioti, Christine Booth, Stephen D Marks
OS of tacrolimus prepared from tacrolimus powder is not licensed for children. A licensed GF for OS allows flexibility for body weight-based dose adjustments. This study aimed at exploring the efficacy of conversion from OS to the GF of tacrolimus in stable pediatric renal transplant recipients. Records of 25 pediatric renal transplant recipients aged under 18 years who were switched from an unlicensed tacrolimus OS to GF were reviewed. At day 0, 1 week, and 4-8 weeks post-conversion, there were no differences regarding daily tacrolimus dose (3...
May 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29753542/children-with-chronic-disease-bear-the-highest-burden-of-pediatric-sepsis
#4
Andrew J Prout, Victor B Talisa, Joseph A Carcillo, Florian B Mayr, Derek C Angus, Christopher W Seymour, Chung-Chou H Chang, Sachin Yende
OBJECTIVE: To describe the contemporary epidemiology of pediatric sepsis in children with chronic disease, and the contribution of chronic diseases to mortality. We examined the incidence and hospital mortality of pediatric sepsis in a nationally representative sample and described the contribution of chronic diseases to hospital mortality. STUDY DESIGN: We analyzed the 2013 Nationwide Readmissions Database using a retrospective cohort design. We included non-neonatal patients <19 years of age hospitalized with sepsis...
May 9, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29750317/mycophenolate-mofetil-for-sustained-remission-in-nephrotic-syndrome
#5
Uwe Querfeld, Lutz T Weber
The clinical application of mycophenolate mofetil (MMF) has significantly widened beyond the prophylaxis of acute and chronic rejections in solid organ transplantation. MMF has been recognized as an excellent treatment option in many immunologic glomerulopathies. For children with frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS) experiencing steroid toxicity, MMF has been recommended as a steroid-sparing drug. Uncontrolled studies in patients with FRNS and SDSN have shown that many patients can achieve sustained remission of proteinuria with MMF monotherapy...
May 11, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29729082/a-case-series-of-perioperative-variables-in-relation-to-short-term-outcomes-in-pediatric-renal-transplant-recipients
#6
Celine Y Y Goh, Helen Hume-Smith, Nicos Kessaris, Stephen D Marks
Multiple perioperative variables have been shown in existing literature to influence long-term outcomes of pediatric RTx, such as allograft survival. Their impact on short-term outcomes is not as well-documented. This case series aims to investigate the effects of nine perioperative variables on two short-term outcomes in pRTR: 1-week post-operative eGFR and post-operative LOS. A total of 73 pRTR transplanted over 3 years from 2012 to 2014 at a single center were studied retrospectively and statistical analyses were performed...
May 5, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29729061/side-effects-and-efficacy-of-renal-sparing-immunosuppression-in-pediatric-liver-transplantation-a-single-center-matched-cohort-study
#7
Christoph Leiskau, Jeremy Rajanayagam, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, André Karch, Christian Lerch, Nicolas Richter, Frank Lehner, Harald Schrem, Ulrich Baumann
Immunosuppressive combination therapy with MMF can reduce CNI associated nephrotoxicity. We investigated effectiveness and safety of de novo MMF-tacrolimus based immunosuppression after pLTx. Patients after pLTx receiving immunosuppression with MMF/tacrolimus (MMF/TAC) were compared to retrospectively selected age- and diagnosis-matched patients with tacrolimus monotherapy (TAC) and cyclosporine/prednisolone therapy (CSA) (19 patients each, n = 57). Effectiveness, renal function and side effects were analyzed for 1 year after pLTx...
May 5, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29725772/benefits-and-risks-of-protocol-biopsies-in-pediatric-renal-transplantation
#8
Roberto Gordillo, Raj Munshi, Eric J Monroe, Giridhar M Shivaram, Jodi M Smith
Protocol biopsies are defined as sampling of allograft tissue at predetermined times regardless of function. This procedure can be justified due to the lack of non-invasive methods to reliably diagnose rejection (acute or subclinical). Changes in creatinine are not seen with subclinical rejection or early acute rejection and do not always correlate with efficacy of treatment. Parents and providers are still hesitant to pursue protocol biopsy due to the potential complications and lack of definitive evidence of a benefit from doing this procedure...
May 3, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29701351/heart-transplantation-early-results-of-two-different-regimes-of-immnunosuppression
#9
Carlos Branco, David Prieto, André Antunes, Manuel Batista, Manuel J Antunes
INTRODUCTION: The management of induction and maintenance immunosuppression therapy after heart transplantation (HT) remains a controversial issue. The dosage and the timing has been a changing target. We aimed at evaluate the incidence of acute cellular rejection (ACR) [≥1R grade], major infection and survival in first year after HT in patients receiving two different induction immunosuppression regimes and with a reduction in intensity of triple maintenance immunosuppression dose...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696778/evolution-of-renal-function-and-urinary-biomarker-indicators-of-inflammation-on-serial-kidney-biopsies-in-pediatric-kidney-transplant-recipients-with-and-without-rejection
#10
Christine M Mincham, Ian W Gibson, Atul Sharma, Chris Wiebe, Rupasri Mandal, David Rush, Peter Nickerson, Julie Ho, David S Wishart, Tom D Blydt-Hansen
Urinary CXCL10 and metabolites are biomarkers independently associated with TCMR. We sought to test whether these biomarkers fluctuate in association with histological severity of TCMR over short time frames. Forty-nine pairs of renal biopsies obtained 1-3 months apart from 40 pediatric renal transplant recipients were each scored for TCMR acuity score (i + t; Banff criteria). Urinary CXCL10:Cr and TCMR MDS were obtained at each biopsy and were tested for association with changes between biopsies in acuity, estimated GFR (ΔeGFR), and 12-month ΔeGFR...
April 25, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29665156/ribavirin-therapy-of-hepatitis-e-infection-may-cause-hyporegenerative-anemia-in-pediatric-renal-transplant-patients
#11
Verena Klämbt, Marcus Panning, Maximilian Seidl, Karsten Häffner, Martin Pohl
HEV infection can lead to chronic hepatitis in immunosuppressed patients; extrahepatic manifestations are rarely seen. Here, we report a 13-year-old renal transplant patient with chronic hepatitis E and renal involvement. Ribavirin therapy led to temporary virus clearance and amelioration of kidney function. However, ribavirin therapy caused severe hyporegenerative anemia, which has so far only been reported in patients treated with a combination of ribavirin and interferon alpha.
April 17, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29662050/does-vitamin-d-affect-chronic-renal-allograft-function-in-pediatric-transplant-patients
#12
Brooke Wile, Elisa Yoo, Ana Catalina Alvarez Elias, Lakshmimathy Subramanian, Kathryn Eager, Ajay Parkesh Sharma, Guido Filler
BACKGROUND Correction of hypovitaminosis D is simple, but it is unclear whether it is associated with an accelerated decline of renal allograft function in pediatric renal transplantation patients. This retrospective single center cohort study aimed at analyzing the effect of vitamin D and covariates on the slope of 1/creatinine after the first year. MATERIAL AND METHODS After ethics committee approval, 37 (14 male) pediatric renal transplant recipients on mycophenolate mofetil, who were followed between 2006 and 2014, were included in this study...
April 17, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29661459/midpole-ureterocalycostomy-for-renal-transplant-salvage-a-pediatric-case-report
#13
P D Imani, J T White, M Michael, K T Puttmann, C A O'Mahony, C J Koh
BACKGROUND: Ureteral obstruction is the most common urological complication of kidney transplantation. Obstruction secondary to ureteral stenosis can be an early or late complication. CASE REPORT: We present a patient in whom ureteral obstruction was initially identified at 2.5 months after transplant for which she underwent a midpole ureterocalycostomy between the midpole calyx of the transplant kidney and the native left ureter.
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#14
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29630083/renal-microsporidiosis-in-pediatric-bone-marrow-transplant-recipients-a-case-series
#15
Saloni Shah, Sheba Sweetline Jacob, Rama Mani, Ashok Parameswaran, Sunil Kumar, Rajeev A Annigeri, Raja Mahesh, Ramya Uppuluri
Microsporidiosis is a rare, but emerging opportunistic infection in solid organ transplant and stem cell transplant recipients. Renal involvement in microsporidiosis is very rarely seen in these recipients. We describe two cases of pediatric renal microsporidiosis, diagnosed on renal biopsies, following bone marrow transplantation presenting as severe acute kidney injury. The first patient died, whereas the second survived due to early diagnosis based on high index of suspicion and prompt treatment with Albendazole...
April 9, 2018: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/29626241/infectious-disease-risks-in-pediatric-renal-transplantation
#16
REVIEW
Felicia A Scaggs Huang, Lara Danziger-Isakov
Renal transplantation is a vital treatment option in children with ESRD with more than 10,000 pediatric kidney transplants and survival rates of greater than 80% at 10 years post-transplant in the USA alone. Despite these advances, infection remains a significant cause of morbidity in pediatric recipients. Screening potential organ donors and recipients is imperative to identify and mitigate infectious risks in the transplant patient. Despite the unique risks of each patient, the timing of many infections post-transplant is predictable...
April 6, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29625558/predominant-but-silent-c1q-deposits-in-mesangium-on-transplanted-kidneys-long-term-observational-study
#17
Takahiro Kanai, Yuko Akioka, Kenichiro Miura, Masataka Hisano, Junki Koike, Yutaka Yamaguchi, Motoshi Hattori
BACKGROUND: C1q nephropathy (C1qN) was first described as glomerular disease characterized by predominant meangial C1q deposits in patients with proteinuria and no evidence of systemic lupus erythematosus. Several studies, however, revealed the clinical heterogeneity of C1qN, showing some cases with normal urinalysis. To confirm the existence of cases with predominant mesangial C1q deposits and negative or mild proteinuria and/or hematuria, we investigated renal graft biopsy specimens showing negative to mild proteinuria (less than or equal to 1+ by dip stick test) and/or hematuria...
April 6, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29617835/patient-and-transplant-outcome-in-infants-starting-renal-replacement-therapy-before-2-years-of-age
#18
Julien Hogan, Justine Bacchetta, Marina Charbit, Gwenaelle Roussey, Robert Novo, Michel Tsimaratos, Joelle Terzic, Tim Ulinski, Arnaud Garnier, Elodie Merieau, Jérôme Harambat, Isabelle Vrillon, Olivier Dunand, Denis Morin, Etienne Berard, Francois Nobili, Cécile Couchoud, Marie-Alice Macher
Background: Despite major technical improvements in the care of children requiring renal replacement therapy (RRT) before 2 years of age, the management of those patients remains challenging and transplantation is generally delayed until the child weighs 10 kg or is 2 years old. In this national cohort study, we studied patient and graft survival in children starting RRT before 2 years of age to help clinicians and parents when deciding on RRT initiation and transplantation management...
March 29, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29605164/renal-function-outcomes-in-pediatric-patients-with-symptomatic-reflux-into-the-transplanted-kidney-treated-with-redo-ureteroneocystostomy
#19
Mary K Wang, Kai-Wen Chuang, Yi Li, Thomas Gaither, Paul Brakeman, Lynette Gonzalez, Jessica Brennan, Laurence S Baskin
INTRODUCTION: Asymptomatic post-renal transplant reflux is common but only 5-10% patients are diagnosed with vesico-ureteral reflux in the setting of post-transplant febrile urinary tract infections, requiring redo ureteroneocystostomy (redo-UNC). Here we report the renal function outcomes of 37 such patients, stratified by lower urinary tract (LUT) status. OBJECTIVE: We hypothesized that those with pre-transplant LUT dysfunction would have lower glomerular filtration rate (GFR) on follow-up...
March 14, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29603431/durability-of-the-hepatitis-b-vaccination-in-pediatric-renal-transplant-recipients
#20
Hilary Miller-Handley, Grant Paulsen, David K Hooper, Michael Lake, Danielle Lazear, Lara Danziger-Isakov
Since hepatitis B virus (HBV) vaccine implementation, HBV infection has significantly decreased. However, adult renal transplant recipients show a higher rate of seroreversion compared to the general population, leading to HBV infection risk. Data are limited in pediatric renal transplant recipients. Retrospective data were collected to determine the seroprotection and durability of HBV vaccination in pediatric renal transplant patients from 2004 to 2014. One hundred subjects were categorized based on pre- and post-transplant hepatitis B surface antibody (HBsAb)...
March 30, 2018: Clinical Transplantation
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