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Heart transplantation pediatric

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https://www.readbyqxmd.com/read/28100970/sickle-cell-disease-with-cyanotic-congenital-heart-disease-long-term-outcomes-in-5-children
#1
Glen J Iannucci, Olufolake A Adisa, Matthew E Oster, Michael McConnell, William T Mahle
Sickle cell disease is a risk factor for cerebrovascular accidents in the pediatric population. This risk is compounded by hypoxemia. Cyanotic congenital heart disease can expose patients to prolonged hypoxemia. To our knowledge, the long-term outcome of patients who have combined sickle cell and cyanotic congenital heart disease has not been reported. We retrospectively reviewed patient records at our institution and identified 5 patients (3 girls and 2 boys) who had both conditions. Their outcomes were uniformly poor: 4 died (age range, 12 mo-17 yr); 3 had documented cerebrovascular accidents; and 3 developed ventricular dysfunction...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#2
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28097735/autoimmune-enteropathy-and-hepatitis-in-pediatric-heart-transplant-recipient
#3
Kimberly Lewis, Ryan Butts, J Antonio Quiros, Michelle Hudspeth, Katherine Twombley, Andrew Savage, Sally Self, Ali Burnette, Shaoli Sun
AIE is a rare disorder in children that presents with severe diarrhea and malabsorption, caused by immune-mediated damage to intestinal mucosa. AIE is often associated with various syndromes of immunodeficiency including IPEX syndrome (immune dysregulation, polyendocrinopathy and enteropathy, X-linked). Dysfunctional T regulatory cells are the source of pathology in both IPEX syndrome and AIE as they are essential in maintaining tolerance to self-antigens and eliminating autoreactive B cells. This case report describes a 10-year-old cardiac transplant and total thymectomy patient on chronic immunosuppression with tacrolimus that presented with AIE and extraintestinal manifestations of cyclical hepatitis...
January 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28073609/interaction-of-older-donor-age-and-survival-after-weight-matched-pediatric-heart-transplantation
#4
Thomas C Westbrook, David L S Morales, Muhammad S Khan, Roosevelt Bryant, Chesney Castleberry, Clifford Chin, Farhan Zafar
BACKGROUND: Donors are matched for weight in pediatric heart transplantation (PHT), yet age differences are not considered in this decision. In this study we attempt to identify the effect of age differences in weight-matched patients and the effect these differences have on post-transplant survival. METHODS: The United Network of Organ Sharing (UNOS) database was queried for the period from October 1987 to March 2014 for all pediatric heart transplant patients...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28070248/childhood-cardiomyopathies-a-study-in-tertiary-care-hospital-in-upper-egypt
#5
Mohamed Abd Elaal Bakeet, Montaser Mohamed Mohamed, Ahmed Ahmed Allam, Rania Gamal
INTRODUCTION: Cardiomyopathy (CMP) is defined by the World Health Organization (WHO) as a disease of the myocardium associated with cardiac dysfunction. An understanding of CMP is very important, as it is a common cause of heart failure in children, and the most common indication for heart transplantation in children older than one year, but data on CMP in Egypt are scarce. The aim of this study was to determine the number, risk factors, clinical presentation, complications and outcome of different types of childhood cardiomyopathies in Sohag University Hospital...
November 2016: Electronic Physician
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#6
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28058227/magnetic-resonance-imaging-of-the-transplanted-pediatric-heart-as-a-potential-predictor-of-rejection
#7
Steven C Greenway, Frederic Dallaire, Paul F Kantor, Anne I Dipchand, Rajiv R Chaturvedi, Monali Warade, Eugenie Riesenkampff, Shi-Joon Yoo, Lars Grosse-Wortmann
AIM: To evaluate cardiac magnetic resonance imaging (CMR) as a non-invasive tool to detect acute cellular rejection (ACR) in children after heart transplant (HT). METHODS: Thirty pediatric HT recipients underwent CMR at the time of surveillance endomyocardial biopsy (EMB) and results were compared to 14 non-transplant controls. Biventricular volumes, ejection fractions (EFs), T2-weighted signal intensities, native T1 times, extracellular volumes (ECVs) and presence of late gadolinium enhancement (LGE) were compared between patients and controls and between patients with International Society of Heart and Lung Transplantation (ISHLT) grade ≥ 2R rejection and those with grade 0/1R...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28058224/persistent-epstein-barr-viral-load-in-epstein-barr-viral-na%C3%A3-ve-pediatric-heart-transplant-recipients-risk-of-late-onset-post-transplant-lymphoproliferative-disease
#8
Bibhuti Das, Robert Morrow, Rong Huang, David Fixler
AIM: To examine the risk of late-onset post-transplant lymphoproliferative disorder (PTLD) in the presence of persisting high Epstein-Barr virus (EBV) in EBV naïve pediatric heart transplant (HT) recipients. METHODS: A retrospective review of the medical records of the 145 pediatric HT recipients who had serial EBV viral load monitoring at our center was performed. We defined EBV naive patients whose EBV serology either IgM or IgG in the blood were negative at the time of HT and excluded passive transmission from mother to child in subjects less than 6 mo of age...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28052610/optn-srtr-2015-annual-data-report-heart
#9
M Colvin, J M Smith, M A Skeans, L B Edwards, K Uccellini, J J Snyder, A K Israni, B L Kasiske
The number of heart transplant candidates and transplants performed continued to rise each year. In 2015, 2819 heart transplants were performed. In addition, the number of new adult candidates on the waiting list increased 51% since 2004. The number of adult heart transplant survivors continued to increase, and in 2015, 29,172 recipients were living with heart transplants. Patient mortality following transplant has declined. The number of pediatric candidates and transplants performed also increased. New listings for pediatric heart transplants increased from 451 in 2004 to 644 in 2015...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28041955/cardiac-dysfunction-in-children-and-young-adults-with-heart-transplantation-a-comprehensive-echocardiography-study
#10
Marcello Chinali, Claudia Esposito, Giorgia Grutter, Roberta Iacobelli, Alessandra Toscano, Maria Grazia D'Asaro, Alessia Del Pasqua, Gianluca Brancaccio, Francesco Parisi, Fabrizio Drago, Gabriele Rinelli
BACKGROUND: Transplanted heart dysfunction is a serious life-threatening condition in pediatric transplant recipients. Several studies have focused on echocardiographic detection of early signs of cardiac dysfunction in this population. We evaluated advanced echocardiographic indices of cardiac function in a large sample of children and young adults with heart transplants with apparently normal cardiac function. METHODS: The study included 60 patients with normal ejection fraction with transplantation performed at pediatric age between 1986 and 2014 and 60 healthy control subjects...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28040759/novel-application-of-a-percutaneous-left-ventricular-assist-device-as-a-bridge-to-transplant-in-a-paediatric-patient-with-severe-heart-failure-due-to-viral-myocarditis
#11
Paul Perry, Elizabeth David, Broadus Atkins, Gary Raff
A 13-year obese female with suspected viral myocarditis presented with acute decompensated heart failure. Due to her body habitus, she was a poor candidate for immediate heart transplantation. A peripherally inserted left ventricular assist device (LVAD) was implanted via the right axillary artery. Following device insertion the patient experienced rapid improvement in symptoms. The LVAD provided effective left ventricular unloading for 50 days, promoting myocardial recovery and maintaining excellent patient performance status...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28033083/the-hemodynamic-effects-and-safety-of-repetitive-levosimendan-infusions-on-children-with-dilated-cardiomyopathy
#12
Pertti Suominen, Niklas Mattila, Olle Nyblom, Paula Rautiainen, Maila Turanlahti, Otto Rahkonen
BACKGROUND: Limited treatment options are available for children with decompensated dilated cardiomyopathy (DCM), while they wait for either functional recovery or heart transplantation. We evaluated the safety of repetitive levosimendan infusions and short-term and long-term impacts of the therapy in this patient population. METHODS: Eighty-one repetitive levosimendan infusions administered to 20 patients with DCM at severe or end stage of the disease in the pediatric intensive care unit were analyzed retrospectively...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28029575/use-of-sirolimus-in-pediatric-heart-transplant-patients-a-multi-institutional-study-from-the-pediatric-heart-transplant-study-group
#13
Joseph W Rossano, John L Jefferies, Elfriede Pahl, David C Naftel, Elizabeth Pruitt, Kathy Lupton, William J Dreyer, Richard Chinnock, Gerard Boyle, William T Mahle
BACKGROUND: Proliferation signal inhibitors, such as sirolimus, are increasingly used in solid-organ transplantation. However, limited data exist on sirolimus-treated pediatric patients. We aimed to describe sirolimus use in pediatric heart transplant patients and test the hypothesis that sirolimus use is associated with improved outcomes. METHODS: A retrospective review and propensity-matched analysis of the Pediatric Heart Transplant Study database was performed on patients undergoing primary heart transplantation from 2004 to 2013 with at least 1 year of follow-up comparing patients treated vs not treated with sirolimus at 1 year after transplant...
October 4, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28009713/outcomes-and-trends-of-ventricular-assist-device-selection-in-children-with-end-stage-heart-failure
#14
Jacob R Miller, Timothy S Lancaster, Deirdre J Epstein, Nicholas C DuPont, Kathleen E Simpson, Chesney Castleberry, Charles E Canter, Pirooz Eghtesady, Umar S Boston
We aimed to examine trends in VAD selection, continuous-flow devices (CFD) versus pulsatile (PFD), and their associated outcomes in children eligible for both device types. To accomplish this, the United Network for Organ Sharing database was reviewed for pediatric patients listed for heart transplant (HT) from January of 2007 through June of 2014. Patients were included if a durable VAD was present at wait listing or when removed from the waiting list, and who met size eligibility for a CFD (BSA > 1.0 m2)...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28000002/stress-perfusion-magnetic-resonance-imaging-to-detect-coronary-artery-lesions-in-children
#15
Chodchanok Vijarnsorn, Michelle Noga, Daryl Schantz, Dion Pepelassis, Edythe B Tham
BACKGROUND: Stress perfusion cardiovascular magnetic resonance (CMR) is used widely in adult ischemic heart disease, but data in children is limited. We sought to evaluate feasibility, accuracy and prognostic value of stress CMR in children with suspected coronary artery disease (CAD). METHODS: Stress CMR was reviewed from two pediatric centers over 5 years using a standard pharmacologic protocol. Wall motion abnormalities, perfusion deficits and late enhancement were correlated with coronary angiogram (CAG) when available, and clinical status at 1 year follow-up for major adverse cardiovascular events (MACE; coronary revascularization, non-fatal myocardial infarction and death due to CAD) was recorded...
December 20, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27999550/the-use-of-berlin-heart-excor-vad-in-children-less-than-10-kg-a-single-center-experience
#16
Arianna Di Molfetta, Fabrizio Gandolfo, Sergio Filippelli, Gianluigi Perri, Luca Di Chiara, Roberta Iacobelli, Rachele Adorisio, Isabella Favia, Alessandra Rizza, Giuseppina Testa, Matteo Di Nardo, Antonio Amodeo
Objective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality are smallest patients namely the ones implanted in the first year of life or with a lower body surface area. This work aims at retrospective reviewing a single center experience in using BHE in children with a body weight under 10 kg...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27976480/social-framework-of-pediatric-heart-recipients-who-have-survived-more-than-15-post-transplant-years-a-single-center-experience
#17
Hannah Copeland, Anees Razzouk, Allison Beckham, Richard Chinnock, Nahidh Hasaniya, Leonard Bailey
To evaluate social development of pediatric heart transplant (tx) recipients who have lived 15 or more years after transplantation. Among 498 pediatric patients, age less than 18 years, who underwent heart transplantation, at a single institution, 337 were performed between 1985 and 1998. We identified all who survived more than 15 years and engaged them in a survey regarding employment, education, marital, and social status. One hundred and eighty-three recipients (54.3%; 183/337) have survived greater than 15 years; of these, 150 (81...
December 15, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27966039/magnetic-resonance-tissue-phase-mapping-demonstrates-altered-left-ventricular-diastolic-function-in-children-with-chronic-kidney-disease
#18
Charlotte Gimpel, Bernd A Jung, Sabine Jung, Johannes Brado, Daniel Schwendinger, Barbara Burkhardt, Martin Pohl, Katja E Odening, Julia Geiger, Raoul Arnold
BACKGROUND: Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease. OBJECTIVE: To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease. MATERIALS AND METHODS: Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle...
December 13, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27938315/epilepsy-after-heart-transplant-a-single-center-experience
#19
Ruhsen Öcal, Taner Sezer, Seda Kibaroğlu, Eda Derle, Sibel Benli, Atilla Sezgin, Sait Aşlamacı
OBJECTIVES: Cardiac transplant is the best treatment for patients with end-stage heart failure. Neurologic complications occur at a rate of 30% to 80% in patients undergoing cardiac transplant. Seizures occur at a rate of 2% to 20%. The main causative factors include immunosuppressant drug toxicity, infections, brain lesions, and metabolic disorders. Here, our aim was to determine seizure types and associated conditions in patients undergoing cardiac transplant and to report our treatment experience at our institution...
December 12, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#20
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
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