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pediátric liver transplant

Hyun-Seok Cho, Wook-Jong Kim, Byungdoo Andrew Lee, Junki Cho, Won-Jung Shin, Gyu-Sam Hwang
Structural alterations in the cirrhotic heart may contribute to electromechanical abnormalities, represented by QT prolongation. The aim of this study was to investigate the changes in QTc according to the operative stage during pediatric LT and to identify which baseline echocardiographic parameters were associated with intraoperative QTc prolongation. Data were evaluated from 39 children undergoing LT for chronic liver disease (median age 9 months). In 19 patients (48.7%), baseline QTc was prolonged ≥440 ms (462 ± 19 ms)...
June 15, 2018: Pediatric Transplantation
Richard S Mangus, Joel R Schroering, Taylor J Hathaway, Chandrashekhar A Kubal, Jonathan A Fridell
UW and HTK solutions are the two primary organ preservation solutions most used in the United States. This study analyzes use of the two solutions in all pediatric liver transplants performed at a single center between 2001and 2017. Outcome measures included early graft function, as well as graft and patient survival. Bile duct complications were reviewed. Operative technique, immunosuppressive protocols, and donor acceptance criteria remained uniform among participating surgeons throughout the study period...
June 15, 2018: Pediatric Transplantation
Divyanshoo R Kohli, Tilak U Shah, Doumit S BouHaidar, Ravi Vachhani, M Shadab Siddiqui
INTRODUCTION: Current practice guidelines recommend prophylactic antibiotics prior to endoscopic retrograde cholangiopancreatography (ERCP) in liver transplant recipients (LTR). This study evaluated the risk of clinically significant infections after ERCP in LTR who received antibiotic prophylaxis compared to those who did not. METHODS: This retrospective case-cohort study evaluated all LTR who underwent elective, outpatient ERCP from 2008 to 2015. Hospitalized patients, pediatric allograft recipients and patients with cholangitis or incomplete biliary drainage were excluded...
May 28, 2018: Digestive and Liver Disease
Vikrant Sood, Bikrant Bihari Lal, Dinesh Rawat, Rajeev Khanna, Archana Rastogi, Chhagan Bihari, Guresh Kumar, Seema Alam
OBJECTIVES: There is limitedliterature on the spectrum of pediatric autoimmune liver disease (AILD, encompassing both autoimmune hepatitis/AIH and autoimmune sclerosing cholangitis/ASC) in Asian populations and its diagnostic scores similarly require further validation. This work thus aimed to study the clinical characteristics, and to validate available diagnostic criteria in the local pediatric AILD cohort. METHODS: A review of all pediatric AILD cases, presenting over a 6 year (2011-2017) period was done, along with comparison of the available diagnostic scores: original (1999), simplified (2008) score and new proposed (2017) score...
June 12, 2018: Journal of Pediatric Gastroenterology and Nutrition
R J Arasaratnam, I Tzannou, T Gray, P I Aguayo-Hiraldo, M Kuvalekar, S Naik, A Gaikwad, H Liu, T Miloh, J F Vera, R W Himes, F M Munoz, A M Leen
Immunosuppression following solid organ transplantation (SOT) has a deleterious effect on cellular immunity leading to frequent and prolonged viral infections. To better understand the relationship between post-transplant immunosuppression and circulating virus-specific T cells, we prospectively monitored the frequency and function of T cells directed to a range of latent (CMV, EBV, HHV6, BK) and lytic (AdV) viruses in 16 children undergoing liver transplantation for up to 1 year post-transplant. Following transplant, there was an immediate decline in circulating virus-specific T cells, which recovered post-transplant, coincident with the introduction and subsequent routine tapering of immunosuppression...
June 13, 2018: American Journal of Transplantation
Alex Toft, Rachel Taylor, Lee Claridge, Charlotte Clowes, James Ferguson, Jonathon Hind, Rebecca Jones, Patricia McClean, Patrick McKiernan, Marianne Samyn, Jane Coad
BACKGROUND: The period of transition from pediatric to adult services represents a time when young people need support, information, and appropriate care in order to successfully move. It is a period that is associated with nonadherence and disengagement with care. OBJECTIVE: To explore the experiences of young liver transplant recipients transitioning to adult services and determine what they require in order to achieve a successful move. The research also explored the possibility of using a mobile phone application (app) as a tool to support transition...
January 1, 2018: Progress in Transplantation
Eva Tschiedel, Roland Assert, Ursula Felderhoff-Müser, Simone Kathemann, Oliver Witzke, Peter Hoyer, Christian Dohna-Schwake
INTRODUCTION AND AIM: Procalcitonin is widely used as a biomarker to distinguish bacterial infections from other etiologies of systemic inflammation. Little is known about its value in acute liver injury resulting from intoxication with paracetamol. MATERIAL AND METHODS: We performed a single-center retrospective analysis of the procalcitonin level, liver synthesis, liver cell damage and renal function of patients admitted with paracetamol-induced liver injury to a tertiary care children's hospital...
July 2018: Annals of Hepatology
Rebecca Epperly, John Ozolek, Kyle Soltys, Debra Cohen, Rakesh Goyal, Erika Friehling
Post-transplant lymphoproliferative disorder (PTLD) related plasma cell neoplasms are rare in pediatric patients. We report a pediatric liver transplant recipient with plasma cell myeloma type PTLD. Cytogenetics included 1q duplication, associated with poor prognosis in adult multiple myeloma, and t(8;14). High-risk cytogenetics has not been reported in pediatric plasma cell myeloma type PTLD. The patient was treated with bortezomib, dexamethasone, and lenalidomide with subsequent autologous stem cell transplant...
June 12, 2018: Pediatric Blood & Cancer
Grant Paulsen, Samantha Blum, Lara Danziger-Isakov
MRSA infection following SOT is an important cause of morbidity and mortality, but epidemiology and risk factors for colonization prior to pediatric SOT remain unclear. A retrospective cohort of SOT patients ≤21 years of age from 2009 to 2014 was evaluated. Demographics, MRSA screens, timing of transplantation, and MRSA infection were abstracted. From 2013 to 2014, 130 SOT candidates were screened or had known prior MRSA infection. Seventeen patients (13%) were MRSA colonized. Liver transplant candidates were least likely to be colonized (OR 0...
June 11, 2018: Pediatric Transplantation
Nathalie Rock, Marc Ansari, Jean Villard, Sylvie Ferrari-Lacraz, Sophie Waldvogel, Valérie Anne McLin
Immune-mediated hemolytic anemia following SOT is a rare disorder, the risk factors for which are unknown. Our purpose was to analyze a seemingly increased incidence in our center with the aim to identify predisposing factors. This recipients single-center retrospective study reviewed the medical records of 96 pediatric LT between 2000 and 2013. IHA was defined as acute anemia with a positive direct antiglobulin test. Seven cases of immune-mediated hemolytic anemia were identified (incidence 8.5%). Three cases presented during the first 3 months following LT (early IHA), and 4 presented later (late IHA)...
June 8, 2018: Pediatric Transplantation
A P Cazzolla, K Zhurakivska, D Ciavarella, M G Lacaita, G Favia, N F Testa, G Marzo, V La Carbonara, G Troiano, L Lo Muzio
AIMS: The aim of this study is to report the case of the orthodontic treatment in a patient affected by primary hyperoxaluria type 1 and subjected to a combinate liver-kidney transplant. METHODS AND RESULTS: The 9-year patient was admitted to our department for the presence of facial dysmorphism. The patient was affected by primary hyperoxaluria type 1 and has undergone a combined liver-kidney transplantation. At the time of the visit, he was in treatment with immunosuppressive drugs and received a corticosteroid and an antibiotic therapy monthly...
June 8, 2018: Special Care in Dentistry
Sahana Shankar, Rishi Bolia, Alexandra Hodgson, Jonathan R Bishop, Helen M Evans, Mark R Oliver
We report the first two pediatric patients with CF who underwent successful combined liver-pancreas transplantation in Australia and New Zealand for CF liver disease and CF-related diabetes mellitus.
June 6, 2018: Pediatric Transplantation
Kuo-Hsin Chen, Tiing Foong Siow, U-Chon Chio, Jiann-Ming Wu, Kuo-Shyang Jeng
Laparoscopic liver resection has been applied to treat most indications for liver resection during the past two decades. According to the literature, patient numbers have increased exponentially as a result, and surgical difficulty has increased as well. In expert centers, laparoscopic anatomical hemihepatectomy and major liver resection more than 3 segments have become the acceptable treatment. Moreover, with surgical innovations and accumulated experience, living donor liver transplantation has become an established treatment choice for patients on the transplant waiting list...
May 2018: Asian Journal of Endoscopic Surgery
Babu Lal Meena, Rajeev Khanna, Chhagan Bihari, Archana Rastogi, Dinesh Rawat, Seema Alam
We studied the etiological spectrum, clinicolaboratory and histological profile, and outcome of infants and children under 18 years of age presenting between December 2010 and May 2016 with histological evidence of paucity of intralobular bile ducts (PILBD, bile ducts to portal tract ratio < 0.6) Post-transplant PILBD was excluded. Of 632 pediatric liver biopsies screened, 70 had PILBD-44 were infants. PILBD was classified histologically into destructive (n = 50) and non-destructive PILBD (n = 20)...
June 4, 2018: European Journal of Pediatrics
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
Toshihiro Yasui, Tatsuya Suzuki, Tetsushi Yoshikawa, Hiroshi Yatsuya, Yoshiki Kawamura, Hiroki Miura, Fujio Hara, Shunsuke Watanabe, Naoko Uga, Atsuki Naoe
Differentiation between active and latent viral infection is critical for analysis of HHV-6-associated disease. HHV-6 infection has been associated with several clinical manifestations; however, the precise role of HHV-6 in pediatric LDLT remains unclear. This retrospective cohort study included 33 pediatric patients who received LDLT. All of the recipients were monitored for HHV-6 infection using viral isolation and real-time PCR. HHV-6 infection was observed in 14 of 33 (42.4%) recipients, and HHV-6B infection occurred within 2 weeks after LDLT in 10 of 14 (71...
June 3, 2018: Pediatric Transplantation
Suk Kyun Hong, Nam-Joon Yi, Hak Chang, Sung-Woo Ahn, Hyo-Sin Kim, Kyung Chul Yoon, Hyeyoung Kim, Seong Oh Park, Ung Sik Jin, Kyung Won Minn, Kwang-Woong Lee, Kyung-Suk Suh
BACKGROUND: Liver transplantation (LT) is an excellent treatment option for patients with biliary atresia (BA) who fail portoenterostomy surgery. LT is also increasingly performed in patients with metabolic liver diseases. This study compared the outcomes in pediatric patients who underwent LT for metabolic liver diseases and BA. BASIC PROCEDURES: Data from 237 pediatric patients who underwent primary LT at Seoul National University Hospital from 1988 to 2015, including 33 with metabolic liver diseases and 135 with BA, were retrospectively analyzed...
April 27, 2018: Journal of Pediatric Surgery
Claudia Della Corte, Salvatore Iasevoli, Andrea Dello Strologo, Mariateresa Sanseviero, Valerio Nobili
Nonalcoholic fatty liver disease (NAFLD) represents the most common cause of chronic liver disease in Industrialized Countries in adults and children. It is estimated that NAFLD will become the main indication for liver transplantation in the next decade. NAFLD is also considered the hepatic feature of metabolic syndrome and therefore it is generally associated to the risk of developing some metabolic complications, with negative impact on patient's survival. Today, no pharmacological treatment has been identified for NAFLD, and behavioral approach, based on diet and regular physical exercise, represent the current recommended treatment, even if with disappointing results...
2018: Advances in Food and Nutrition Research
Cindy L Bryce, Chung Chou H Chang, Yi Ren, Jonathan Yabes, Gabriel Zenarosa, Aditya Iyer, Heather Tomko, Robert H Squires, Mark S Roberts
PURPOSE: To distinguish clinical factors that have time-varying (as opposed to constant) impact upon patient and graft survival among pediatric liver transplant recipients. METHODS: Using national data from 2002 through 2013, we examined potential clinical and demographic covariates using Gray's piecewise constant time-varying coefficients (TVC) models. For both patient and graft survival, we estimated univariable and multivariable Gray's TVC, retaining significant covariates based on backward selection...
2018: PloS One
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
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