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Heart transplantation pediatric

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https://www.readbyqxmd.com/read/28453909/cardiotoxicity-and-cardiomyopathy-in-children-and-young-adult-survivors-of-hematopoietic-stem-cell-transplant
#1
REVIEW
Seth J Rotz, Thomas D Ryan, Joel Hlavaty, Stephen A George, Javier El-Bietar, Christopher E Dandoy
Cardiomyopathy is common in long-term survivors of pediatric hematopoietic stem cell transplant (HSCT). Events occurring before and after HSCT when combined with specific insults during HSCT likely contribute to long-term risk. Strategies for detecting subclinical cardiomyopathy prior to patients developing overt heart failure are under investigation. Changes in HSCT preparative regimens and cardioprotective medications administered during chemotherapy may alter the risk for cardiomyopathy. Interventions in long-term survivors such as lifestyle modification and cardioactive medications are of increasing importance...
April 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28424442/clinical-improvement-and-no-further-need-of-transplant-after-closure-of-pda-with-transcatheter-approach-in-an-end-stage-heart-failure-patient-with-hypertrabeculation
#2
Serhat Koca, Feyza Ayşenur Paç, Ajda Mutlu Mıhçıoğlu, Vedat Kavurt, Denizhan Bağrul
Although heart failure is managed medically most of the time, heart transplantation is still last resort for selected end-stage heart failure patients with noncompaction cardiomyopathy. Presently described for the first time is case of pediatric patient with noncompaction cardiomyopathy who was initially referred to our hospital for heart transplant but underwent PDA repair and improved clinically without need for heart transplant.
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28421185/changes-in-composition-of-the-gut-bacterial-microbiome-after-fecal-microbiota-transplantation-for-recurrent-clostridium-difficile-infection-in-a-pediatric-heart-transplant-patient
#3
Kyle L Flannigan, Taylor Rajbar, Andrew Moffat, Leanna S McKenzie, Frank Dicke, Kevin Rioux, Matthew L Workentine, Thomas J Louie, Simon A Hirota, Steven C Greenway
The microbiome is increasingly recognized as an important influence on human health and many of the comorbidities that affect patients after solid organ transplantation (SOT) have been shown to involve changes in gut bacterial populations. Thus, microbiome changes in an individual patient may have important health implications after SOT but this area remains understudied. We describe changes in the composition of the fecal microbiome from a pediatric heart transplant recipient before and >2.5 years after he underwent repeated fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection (CDI)...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28419703/exercise-capacity-following-pediatric-heart-transplantation-a-systematic-review
#4
Sara Peterson, Jennifer A Su, Jacqueline R Szmuszkovicz, Robert Johnson, Barbara Sargent
Pediatric HTs account for 13% of all HTs with >60% of recipients surviving at least 10 years post-HT. The purpose of this systematic review is to synthesize the literature on exercise capacity of pediatric HT recipients to improve understanding of the mechanisms that may explain the decreased exercise capacity. Six databases were searched for studies that compared the exercise capacity of HT recipients ≤21 years old with a control group or normative data. Sixteen studies were included. Pediatric HT recipients, as compared to controls or normative data, exhibit significantly higher resting HR, and at peak exercise exhibit significantly decreased HR, VO2 , power, work, minute ventilation, and exercise duration...
April 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28410774/maintaining-the-gift-of-life-achieving-adherence-in-adolescent-heart-transplant-recipients
#5
Rachael Steuer, Sabrina Opiola McCauley
Since the beginning of United Network of Organ Sharing data collection in 1987, a total of 8,333 pediatric patients have received a heart transplant in the United States. Because these patients now have longer graft success with improved care and immunosuppression, many of them are entering adolescence and young adulthood. Primary care pediatric nurse practitioners need to be alert to the prevalence of noncompliance with treatment in heart transplant patients, which continues to be highest in adolescence. Low compliance in adolescence increases morbidity, contributes to decreasing quality of life, and is the leading reason for graft failure and mortality in this age group...
April 12, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28396164/dose-escalation-of-total-marrow-irradiation-in-high-risk-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#6
Susanta Hui, Claudio Brunstein, Yutaka Takahashi, Todd DeFor, Shernan G Holtan, Veronika Bachanova, Christopher Wilke, Darren Zuro, Celalettin Ustun, Daniel Weisdorf, Kathryn Dusenbery, Michael R Verneris
Patients with refractory leukemia or minimal residual disease (MRD) at transplant have increased risk of relapse. Augmentation of irradiation, especially to sites of disease (i.e., bone marrow) is one potential strategy to overcome this risk. We studied the feasibility of radiation dose escalation in high risk patients using total marrow irradiation (TMI) in a phase I dose-escalation trial. Four pediatric and 8 adult patients received conditioning with cyclophosphamide and fludarabine in conjunction with image-guided radiation to the bone marrow at 15 Gy and 18 Gy (in 3 Gy/fractions), while maintaining the total body irradiation (TBI) dose to the vital organs (lungs, hearts, eyes, liver, kidneys) at <13...
April 7, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#7
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28378408/cancer-recurrence-and-mortality-after-pediatric-heart-transplantation-for-anthracycline-cardiomyopathy-a-report-from-the-pediatric-heart-transplant-study-phts-group
#8
Matthew J Bock, Elfriede Pahl, Paolo G Rusconi, Gerard J Boyle, John J Parent, Clare J Twist, James K Kirklin, Elizabeth Pruitt, Daniel Bernstein
We aimed to determine whether malignancy after pediatric HTx for ACM affects overall post-HTx survival. Patients <18y listed for HTx for ACM in the PHTS database between 1993 and 2014 were compared to those with DCM. A 2:1 matched DCM cohort was also compared. Wait-list and post-HTx survival, along with freedom from common HTx complications, were compared. Eighty subjects were listed due to ACM, whereas 1985 were listed for DCM. Although wait-list survival was higher in the ACM group, post-HTx survival was lower for the ACM cohort...
April 4, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28366553/implications-and-outcomes-of-cardiac-grafts-refused-by-pediatric-centers-but-transplanted-by-adult-centers
#9
Farhan Zafar, Raheel Rizwan, Angela Lorts, Roosevelt Bryant, James S Tweddell, Clifford Chin, David L Morales
BACKGROUND: According to Organ Procurement Transplant Network policy, hearts from donors age <18 years are offered to pediatric recipients before being offered to adults of the same health status. We aimed to analyze differences in the use of adolescent donor hearts between adult and pediatric candidates and also to analyze the outcomes of pediatric candidates in which an adolescent donor heart was refused and later used in an adult recipient. METHODS: All adolescent donors (age 12-17 years) for 2000 to 2015 were identified using the standard United Network of Organ Sharing dataset and matched against the Potential Transplant Recipient dataset...
March 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28365178/pediatric-heart-donor-assessment-tool-ph-dat-a-novel-donor-risk-scoring-system-to-predict-1-year-mortality-in-pediatric-heart-transplantation
#10
Farhan Zafar, Robert D Jaquiss, Christopher S Almond, Angela Lorts, Clifford Chin, Raheel Rizwan, Roosevelt Bryant, James S Tweddell, David L S Morales
BACKGROUND: In this study we sought to quantify hazards associated with various donor factors into a cumulative risk scoring system (the Pediatric Heart Donor Assessment Tool, or PH-DAT) to predict 1-year mortality after pediatric heart transplantation (PHT). METHODS: PHT data with complete donor information (5,732) were randomly divided into a derivation cohort and a validation cohort (3:1). From the derivation cohort, donor-specific variables associated with 1-year mortality (exploratory p-value < 0...
March 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28363739/functional-status-of-united-states-children-supported-with-a-left-ventricular-assist-device-at-heart-transplantation
#11
Anica Bulic, Katsuhide Maeda, Yulin Zhang, Sharon Chen, Doff B McElhinney, John C Dykes, Amanda M Hollander, Seth A Hollander, Jenna Murray, Olaf Reinhartz, Mary Alice Gowan, David N Rosenthal, Christopher S Almond
BACKGROUND: As survival with pediatric left ventricular assist devices (LVADs) has improved, decisions regarding the optimal support strategy may depend more on quality of life and functional status (FS) rather than mortality alone. Limited data are available regarding the FS of children supported with LVADs. We sought to compare the FS of children supported with LVADs vs vasoactive infusions to inform decision making around support strategies. METHODS: Organ Procurement and Transplant Network data were used to identify all United States children aged between 1 and 21 years at heart transplant (HT) between 2006 and 2015 for dilated cardiomyopathy and supported with an LVAD or vasoactive infusions alone at HT...
March 2, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28359495/pediatric-heart-transplantation-with-lecompte-maneuver-owing-to-extremely-oversized-donor-allograft
#12
María-Teresa González-López, Ramón Pérez-Caballero-Martínez, Ana-María Pita-Fernández, Juan-Miguel Gil-Jaurena
The techniques and outcomes of heart transplantation in the pediatric population continue to improve over the years, although the supply of organs remains limited. Donor-to-recipient size matching is critical, especially in neonates and small infants. We present a novel strategy for heart transplantation that includes the Lecompte maneuver because of the features of the donor allograft available in a 8-month-old patient with a cardiac fibroma. We discuss the basis principles for extending the indication of this procedure to exceptional transplantation scenarios and describe the results at long-term follow-up...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28359493/twin-to-twin-heart-transplantation-a-unique-event-with-a-25-year-follow-up
#13
David Blitzer, Grace Yedlicka, Joshua Manghelli, John Dentel, Randall Caldwell, John W Brown
Solid organ transplantation in pediatric patients has been a reality since 1954, when the first kidney transplantation was successfully performed between identical twins. We report the long-term outcomes, with more than 25 years of follow-up, in a patient born with hypoplastic left heart syndrome (HLHS) who received a heart transplant from a dizygotic twin. While we would not wish for this situation to reoccur, we hope that in reporting it, we can add to the discussion surrounding pediatric heart transplantation and the management of HLHS...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28332766/the-effects-of-center-volume-on-mortality-in-pediatric-heart-transplantation-the-rest-of-the-story
#14
EDITORIAL
C E Canter
Paul Harvey was an American radio commentator in the latter part of the twentieth century. He would present vignettes and would finish them with the tag line "now you know the rest of the story". In this issue Rana, et al (1) have analyzed the effects of center transplant volume on outcomes with pediatric heart transplantation. Instead of focusing on outcomes after transplantation, their primary aim was to analyze center volume effects on waitlist mortality- the rest of the story. This article is protected by copyright...
March 23, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28328555/association-of-pediatric-cardiac-surgical-volume-and-mortality-after-cardiac-ecmo
#15
Cindy S Barrett, Titus T Chan, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
Centers with higher surgical and ECMO volume have improved survival for children undergoing pediatric cardiac surgery and ECMO respectively. We examined the relationship between both cardiac surgical and cardiac ECMO volumes, with survival. Using data from the Pediatric Health Information System, we reviewed patients who underwent ECMO during the hospitalization for cardiac surgery or heart transplantation from January 2003- June 2014. Among 106,967 patients in 43 centers undergoing a Risk Adjustment for Congenital Heart Surgery-1 (RACHS) 1-6 procedure (n =104,951) and/or cardiac transplantation (n=2016), 2...
March 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28316109/airway-inflammation-and-symptoms-in-children-following-liver-and-heart-transplantation
#16
Andrew J Redmann, John C Bucuvalas, Robert E Wood, Clifford Chin, Catherine K Hart
OBJECTIVES: To describe the upper airway endoscopic findings of children with upper airway symptoms after liver transplantation (LT) or heart transplantation (HT). METHODS: Review of children undergoing airway endoscopy after LT or HT from 2011 to 2015 at a tertiary care pediatric hospital. Airway findings, biopsy results, immunosuppression, and Epstein-Barr virus (EBV) levels were recorded. RESULTS: Twenty-three of 158 LT (111) and HT (47) recipients underwent endoscopy...
March 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28295963/a-multicenter-study-of-the-impella-device-for-mechanical-support-of-the-systemic-circulation-in-pediatric-and-adolescent-patients
#17
V Vivian Dimas, Brian H Morray, Dennis W Kim, Christopher Sd Almond, Shabana Shahanavaz, Sebastian C Tume, Lynn F Peng, Doff B McElhinney, Henri Justino
OBJECTIVES: The objective was to review the use of Impella devices (Abiomed Inc, Danvers, MA) for temporary circulatory support in pediatric and adolescent patients (age ≤ 21 yrs). BACKGROUND: Options for minimally invasive circulatory support in children are limited, and published data are confined to case reports and small case series. METHODS: This was a retrospective, multicenter review of Impella implants in pediatric and adolescent patients from 2009-15, using standardized data collection and INTERMACS definitions...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295946/feasibility-and-interpretation-of-global-longitudinal-strain-imaging-in-pediatric-heart-transplant-recipients
#18
Bethany L Wisotzkey, Neal W Jorgensen, Erin L Albers, Mariska S Kemna, Robert J Boucek, Richard A Kronmal, Yuk M Law, Aarti H Bhat
Evaluation of myocardial mechanics after heart transplant is important in monitoring allograft function and identifying rejection. Speckle tracking global longitudinal strain (GLS) may be more sensitive to early regional changes from rejection. This study aimed to determine feasibility of GLS in pediatric hearts during surveillance echocardiograms, compare their GLS to published norms (-18% to -22%), and assess association of GLS with other indices of graft function. Retrospective review of transplant echocardiograms from 2013 to 2014...
March 10, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28290258/parent-reports-of-health-related-quality-of-life-and-heart-failure-severity-score-independently-predict-outcome-in-children-with-dilated-cardiomyopathy
#19
Susanna L den Boer, Sara J Baart, Marijke H van der Meulen, Gabriëlle G van Iperen, Ad P Backx, Arend D Ten Harkel, Lukas A Rammeloo, Gideon J du Marchie Sarvaas, Ronald B Tanke, Willem A Helbing, Elisabeth M Utens, Michiel Dalinghaus
BACKGROUND: Dilated cardiomyopathy in children causes heart failure and has a poor prognosis. Health-related quality of life in this patient group is unknown. Moreover, results may provide detailed information of parents' sense of their child's functioning. We hypothesised that health-related quality of life, as rated by parents, and the paediatric heart failure score, as assessed by physicians, have both predictive value on outcome. Methods and results In this prospective study, health-related quality of life was assessed by parent reports: the Infant Toddler Quality of Life questionnaire (0-4 years) or Child Health Questionnaire-Parent Form 50 (4-18 years) at 3-6-month intervals...
March 14, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28289528/clinical-cardiac-regenerative-studies-in-children
#20
REVIEW
Imre J Pavo, Ina Michel-Behnke
Although the incidence of pediatric heart failure is low, the mortality is relatively high, with severe clinical symptoms requiring repeated hospitalization or intensive care treatment in the surviving patients. Cardiac biopsy specimens have revealed a higher number of resident human cardiac progenitor cells, with greater proliferation and differentiation capacity, in the neonatal period as compared with adults, demonstrating the regeneration potential of the young heart, with rising interest in cardiac regeneration therapy in critically ill pediatric patients...
February 26, 2017: World Journal of Cardiology
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