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https://www.readbyqxmd.com/read/29863456/application-of-pediatric-donor-livers-after-circulatory-death-in-adult-liver-transplantation-a-single-center-experience
#1
Rui Zhang, Zhi-Jun Zhu, Li-Ying Sun
OBJECTIVES: This study aimed to investigate the outcomes of adult liver transplant procedures using grafts from pediatric donors after circulatory death. MATERIALS AND METHODS: We retrospectively analyzed the data of 19 pediatric-to-adult liver transplant procedures from July 2013 to May 2016 in our hospital. Nineteen adult liver transplant procedures were performed using livers from pediatric donors after circulatory death. RESULTS: We performed 18 orthotopic and 1 piggyback liver transplant procedure...
June 1, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29851917/acute-liver-failure-outcome-and-value-of-pediatric-end-stage-liver-disease-score-in-pediatric-cases
#2
Raquel Núñez-Ramos, Soledad Montoro, Marcello Bellusci, María Rosa Del Fresno-Valencia, Marta Germán-Díaz, Pedro Urruzuno, Enrique Medina, Javier Manzanares
PURPOSE: The aims of this study were to analyze the characteristics of patients with acute liver failure (ALF) in our center and evaluate the prognostic value of the Pediatric End-Stage Liver Disease (PELD) score calculated at admission. METHODS: A retrospective analysis of patients with ALF younger than 15 years between 2005 and 2013 was performed. Information collected included age, sex, etiology of ALF, laboratory tests, PELD score, stage of encephalopathy, and need for liver support devices such as MARS and/or liver transplant (LT) and survival...
June 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29788811/central-ecmo-for-circulatory-failure-following-pediatric-liver-transplantation
#3
John P Scott, Johnny C Hong, Nathan E Thompson, Ronald K Woods, George M Hoffman
We describe the case of a 4-year-old male with a past medical history significant for nephrotic syndrome, short-bowel syndrome and fulminant hepatic failure status post (s/p) liver transplant (LT) who developed early post-transplant allograft dysfunction (hyperbilirubinemia, coagulopathy) and septic shock requiring central extracorporeal membrane oxygenation (ECMO). He remained on ECMO for 85 hours before he was decannulated without event and later underwent repeat LT. This case highlights the potential of central ECMO to provide the circulatory output necessary to reverse distributive shock physiology in patients with sepsis and hepatic dysfunction following LT...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29766815/old-and-new-treatments-for-pediatric-autoimmune-hepatitis
#4
Silvia Nastasio, Giuseppe Maggiore, Marco Sciveres, Lorenza Matarazzo
Autoimmune hepatitis is a rare inflammatory disease of the liver that most frequently affects children and young adults. It is a multifactorial disease of unknown etiology, characteristically progressive in nature, and if left untreated, may lead to cirrhosis and terminal liver failure. It has been known for several decades now that immunosuppressive treatment convincingly alters the outcome of most patients with autoimmune hepatitis and as such it should be started as soon as diagnosis is made. Primary goals of treatment are: normalization of hepatocellular function, extinction of the hepatic necroinflammatory process, and maintenance of a stable remission, thus preventing progression to cirrhosis and its complications...
May 16, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29749699/histological-findings-in-protocol-biopsies-following-pediatric-liver-transplant-low-incidence-of-abnormalities-at-5-years
#5
Amin Sheikh, Kai Y Chau, Helen M Evans
Histological abnormalities, including chronic hepatitis, fibrosis, and steatosis, are increasingly reported in liver biopsies of children after LT. These changes may be progressive and represent a form of rejection. Liver biochemistry is often initially normal. Our LT program began in 2002, utilizing tacrolimus and low-dose steroids for the first year post-LT. Patients undergo a protocol biopsy at 1 year post-LT prior to stopping steroids, then at 5 years and every 5 years thereafter. Target tacrolimus levels are 5-8 μg/L and 3-5 μg/L after 3 and 12 months, respectively...
May 11, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29746311/evaluating-mortality-risk-adjustment-among-children-receiving-extracorporeal-support-for-respiratory-failure
#6
Ryan P Barbaro, Philip S Boonstra, Kevin W Kuo, David T Selewski, David K Bailly, Cheryl L Stone, Chin Ying Chow, Gail M Annich, Frank W Moler, Matthew L Paden
This study evaluates whether three commonly used pediatric intensive care unit (PICU) severity of illness scores, pediatric risk of mortality score (PRISM) III, pediatric index of mortality (PIM) 2, and pediatric logistic organ dysfunction (PELOD), are the appropriate tools to discriminate mortality risk in children receiving extracorporeal membrane oxygenation (ECMO) support for respiratory failure. This study also evaluates the ability of the Pediatric Risk Estimate Score for Children Using Extracorporeal Respiratory Support (Ped-RESCUERS) to discriminate mortality risk in the same population, and whether Ped-RESCUERS' discrimination of mortality is improved by additional clinical and laboratory measures of renal, hepatic, neurologic, and hematologic dysfunction...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29735030/living-donor-intestinal-transplantation
#7
REVIEW
Ivo G Tzvetanov, Kiara A Tulla, Giuseppe D'Amico, Enrico Benedetti
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29692823/plant-toxins-and-acute-medicinal-plant-poisoning-in-children-a-systematic-literature-review
#8
REVIEW
Adel Ghorani-Azam, Samaneh Sepahi, Bamdad Riahi-Zanjani, Anahita Alizadeh Ghamsari, Seyed Ahmad Mohajeri, Mahdi Balali-Mood
Background: For many years, medicinal plants and herbal therapy have been widely used in different societies for the treatment of various diseases. Besides their therapeutic potency, some of the medicinal plants have strong toxicity in human, especially in children and elderly. Despite common beliefs that natural products are safe, there have been few reports on their toxicities. Materials and Methods: In the present study, we aimed to systematically review the literature wherein acute plant poisoning and herbal intoxication have been reported in pediatric patients...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#9
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/29603342/indeterminate-pediatric-acute-liver-failure-is-uniquely-characterized-by-a-cd103-cd8-t-cell-infiltrate
#10
Catherine A Chapin, Thomas Burn, Tomas Meijome, Kathleen M Loomes, Hector Melin-Aldana, Portia A Kreiger, Peter F Whitington, Edward M Behrens, Estella M Alonso
The cause of pediatric acute liver failure (PALF) is unknown in up to 40% of cases. Evidence suggests aberrant immune system activation may play a role. We hypothesized indeterminate PALF cases would exhibit a unique pattern of hepatic inflammation. This was a retrospective and prospective study of PALF cases due to indeterminate (iPALF), autoimmune hepatitis (AIH), or known diagnosis (dPALF) etiology. Liver tissue sections were stained with immunohistochemical (IHC) markers for cytotoxic T-cells (CD8), perforin, and tissue resident memory T-cells (CD103), and scored as minimal, moderate, or dense...
March 30, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29601455/successful-treatment-of-a-south-african-pediatric-case-of-acute-liver-failure-caused-by-perinatal-transmission-of-hepatitis-b
#11
Nafiisah Chotun, Silvia Strobele, Tongai Gibson Maponga, Monique Ingrid Andersson, Nel Etienne De La Ray
We report on the successful treatment of a South African infant with hepatitis B virus (HBV)-induced acute liver failure using lamivudine with no evidence of clinical resistance. Perinatal HBV transmission occurred despite timely HBV vaccination at 6, 10, and 14 weeks, as per South African vaccination schedule, highlighting the need to introduce the birth-dose HBV vaccine in South Africa.
March 27, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29491755/significant-hyperbilirubinemia-and-acute-hepatocellular-jaundice-in-a-pediatric-patient-receiving-deferasirox-a-case-report
#12
Elizabeth A Feldman, Christopher D Miller, Sarabeth Wojnowicz, Robert Seabury
Despite a boxed warning, postmarketing reports of deferasirox-associated hepatic injury in patients with chronic transfusions are not well described. Hepatic impairment, including failure, has been reported to occur more frequently in patients older than 55 years and in those with significant comorbidities, including liver cirrhosis and multiorgan failure. In this case report, we describe significant hyperbilirubinemia and acute hepatocellular jaundice related to deferasirox in a 7-year-old female being treated for iron overload secondary to chronic transfusions...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29460791/hypercholesterolemia-and-hypertriglyceridemia-as-risk-factors-of-liver-dysfunction-in-children-with-inflammation-receiving-total-parenteral-nutrition
#13
Ana Paula Brigatto Simões Golucci, André Moreno Morcillo, Taís Daiene Russo Hortencio, Antônio Fernando Ribeiro, Roberto José Negrão Nogueira
BACKGROUND AND AIMS: Hepatic dysfunction, due to parenteral nutrition, may become severe and lead to cirrhosis and hepatic failure, especially in newborns and infants. This study aimed to evaluate the association between the exclusive use of total parenteral nutrition (TPN) and changes in the hepatic profile, and to investigate the relationship between age, hypertriglyceridemia, and hypercholesterolemia, and the occurrence of laboratory liver dysfunction. METHODS: A descriptive and historical cohort study was conducted, evaluating 195 pediatric patients (age: 1 month to 19 years) who received TPN...
February 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29443826/higher-risk-of-posttransplant-graft-failure-in-male-recipients-of-female-donor-grafts-might-not-be-due-to-anastomotic-size-disparity
#14
Kyo Won Lee, Sangbin Han, Sanghoon Lee, Hyun-Hwa Cha, Soohyun Ahn, Hyeon Seon Ahn, Justin S Ko, Mi Sook Gwak, Gaab Soo Kim, Jae-Won Joh, Suk-Koo Lee, Gyu-Seong Choi
BACKGROUND: Posttransplant liver graft failure occurs most often in male recipients of livers from female donors. The respective role of donor sex itself and the size disparity in graft vessels/bile ducts according to donor sex are unclear. Thus, we aimed to evaluate the importance of donor sex with adjustment for anastomotic size disparity between female and male donor grafts. METHODS: A total of 309 male patients without hepatic tumors who underwent living donor liver transplantation were analyzed (109 female and 200 male donors)...
February 13, 2018: Transplantation
https://www.readbyqxmd.com/read/29443401/pediatric-intestinal-failure-associated-liver-disease-challenges-in-identifying-clinically-relevant-biomarkers
#15
Kathleen M Gura, Andrew E Mulberg, Paul D Mitchell, John Yap, Clara Y Kim, Minjun Chen, Alexis Potemkin, Mark Puder
BACKGROUND: Intestinal failure-associated liver disease (IFALD) is complex and diagnosed by concurrent use of parenteral nutrition, clinical presentation, and alterations in hepatic biomarkers exclusive of other causes of liver disease. In comparison with individual measures, composite biomarkers may provide a more effective means for assessing disease progression and response to treatment than single parameters. Since IFALD is considered by some to be a type of drug-induced liver injury (DILI), those diagnostic criteria could potentially be used in this population...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29410290/one-thousand-pediatric-liver-transplants-during-thirty-years-lessons-learned
#16
Robert S Venick, Douglas G Farmer, Jose R Soto, Jorge Vargas, Hasan Yersiz, Fady M Kaldas, Vatche G Agopian, Jonathan R Hiatt, Sue V McDiarmid, Ronald W Busuttil
BACKGROUND: Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experience and aimed to identify unique preoperative predictors of early graft and patient survival for primary transplantation (1°-pLTx) and retransplantation (Re-pLTx). STUDY DESIGN: We conducted an IRB-approved, retrospective study of all consecutive, isolated pLTx patients 18 years of age or younger...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29407332/antibody-drug-treatment-for-steroid-resistant-rejection-after-pediatric-living-donor-liver-transplantation-a-single-center-experience
#17
Y Hirata, Y Sanada, T Urahashi, Y Ihara, N Yamada, N Okada, T Katano, S Otomo, K Ushijima, K Mizuta
BACKGROUND: Antibody drugs have been used to treat steroid-resistant rejection (SRR) after liver transplantation. Although anti-thymocyte globulin has been used for SRR after liver transplantation in place of muromonab-CD3 since 2011 in Japan, the effectiveness of anti-thymocyte globulin after pediatric living-donor liver transplantation (LDLT) has not yet been reported. The aim of this study was to evaluate the effectiveness of antibody drug treatment for SRR after pediatric LDLT in our single center...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29402263/effect-of-the-2015-earthquake-on-pediatric-inpatient-pattern-at-a-tertiary-care-hospital-in-nepal
#18
Bishnu Rath Giri, Ram Hari Chapagain, Samana Sharma, Sandeep Shrestha, Sunita Ghimire, P Ravi Shankar
BACKGROUND: Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. METHODS: We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7...
February 5, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29382475/-autoimmune-hepatitis-in-the-pediatric-age
#19
REVIEW
Rubén Peña-Vélez, Enory Almanza-Miranda
In pediatrics, autoimmune hepatitis and sclerosing cholangitis are liver disorders with an immunological damage mechanism. Autoimmune hepatitis is a disease of unknown etiology characterized by interface hepatitis, hypergammaglobulinemia, circulating autoantibodies and a favorable response to immunosuppression. It is an eminently pediatric disease with a prevalent condition in young women. Therapy should be instituted promptly to prevent rapid deterioration, promote remission of disease and long-term survival...
September 2017: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29381934/pregnancy-associated-hemophagocytic-lymphohistiocytosis-secondary-to-nk-t-cells-lymphoma-a-case-report-and-literature-review
#20
Mengzhou He, Jing Jia, Jingyi Zhang, Rajluxmee Beejadhursing, Lali Mwamaka Sharifu, Jun Yu, Shaoshuai Wang, Ling Feng
RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) occurs primarily in pediatric population, or secondary to malignancy, infection, or autoimmune disease. This disease is rare and prognosis is generally poor. Only a small number of cases during pregnancy have been reported in literature. PATIENT CONCERNS: We report a case of pregnancy-associated HLH secondary to natural killer (NK)/T cells lymphoma. She was admitted at 30 weeks and 3 days of pregnancy with complaints of abdominal pain and fever as high as 39...
November 2017: Medicine (Baltimore)
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