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Heart transplantation pediatric

Emilie Jean-St-Michel, Alene Toulany
No abstract text is available yet for this article.
March 14, 2018: Pediatric Transplantation
Lara Danziger-Isakov, William J Steinbach, Grant Paulsen, Flor M Munoz, Leigh R Sweet, Michael Green, Marian G Michaels, Janet A Englund, Alastair Murray, Natasha Halasa, Daniel E Dulek, Rebecca Pellett Madan, Betsy C Herold, Brian T Fisher
Background: Respiratory virus infection (RVI) in pediatric solid organ transplant (SOT) recipients poses a significant risk; however, the epidemiology and effects of an RVI after pediatric SOT in the era of current molecular diagnostic assays are unclear. Methods: A retrospective observational cohort of pediatric SOT recipients (January 2010 to June 2013) was assembled from 9 US pediatric transplant centers. Charts were reviewed for RVI events associated with hospitalization within 1 year after the transplant...
March 10, 2018: Journal of the Pediatric Infectious Diseases Society
Dana M Boucek, Ashwin K Lal, Aaron W Eckhauser, Hsin-Yi Cindy Weng, Xiaoming Sheng, Jacob F Wilkes, Nelangi M Pinto, Shaji C Menon
Pediatric heart transplantation (HT) is resource intensive. Event-driven pediatric databases do not capture data on resource use. The objective of this study was to evaluate resource utilization and identify associated factors during initial hospitalization for pediatric HT. This multicenter retrospective cohort study utilized the Pediatric Health Information Systems database (43 children's hospitals in the United States) of children ≤19 years of age who underwent transplant between January 2007 and July 2013...
January 31, 2018: American Journal of Cardiology
Marianne C Jacobsen, Maria D I Manunta, Emma S Pincott, Matthew Fenton, Gavin L Simpson, Nigel J Klein, Michael Burch
BACKGROUND: Cytomegalovirus (CMV) infection is implicated in endothelial dysfunction and graft damage after pediatric heart transplantation. CMV specific immune responses are thought to be necessary for CMV viral control but there is little data in pediatric heart transplantation. METHODS: We studied 28 consecutive pediatric heart transplant recipients for 1-year posttransplant. CMV-specific T cells expressing IFN-γ, TNF-α and IL-2 in response to ex-vivo stimulation with CMV lysates or peptides were measured...
March 5, 2018: Transplantation
Anne I Dipchand
Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing...
January 2018: Annals of Cardiothoracic Surgery
Kirsten Rose-Felker, Ayesha Mukhtar, Michael S Kelleman, Shriprasad R Deshpande, William T Mahle
Neutropenia has been reported in pediatric heart transplant recipients, but its association with infectious morbidity and mortality is unknown. We sought to determine neutropenia's prevalence and impact on infection, rejection, and survival. A retrospective analysis of pediatric heart transplant recipients from March 2005 to August 2015 was performed. Demographics, medications, infection, and rejection data were collected. Of 142 pediatric heart transplant recipients, 77 (54.2%) developed neutropenia within 4...
February 23, 2018: Pediatric Transplantation
Kalpana Thammineni, Jeffrey M Vinocur, Brian Harvey, Jeremiah S Menk, Michael Scott Kelleman, Anna-Maria Korakiti, Amanda S Thomas, James H Moller, James D St Louis, Lazaros K Kochilas
OBJECTIVE: Surgical coronary revascularisation in children with congenital heart disease (CHD) is a rare event for which limited information is available. In this study, we review the indications and outcomes of surgical coronary revascularisation from the Pediatric Cardiac Care Consortium, a large US-based multicentre registry of interventions for CHD. METHODS: This is a retrospective cohort study of children (<18 years old) with CHD who underwent surgical coronary revascularisation between 1982 and 2011...
February 22, 2018: Heart: Official Journal of the British Cardiac Society
Andrew T Trout, Rachel M Sheridan, Suraj D Serai, Stavra A Xanthakos, Weizhe Su, Bin Zhang, Daniel B Wallihan
Purpose To assess the diagnostic performance of magnetic resonance (MR) elastography-derived liver stiffness to detect liver fibrosis in a pediatric and young adult population with a spectrum of liver diseases. Materials and Methods This retrospective study included patients younger than 21 years of age who underwent MR elastography and liver biopsy within 3 months of one another between January 2012 and September 2016 for indications other than liver transplantation or Fontan palliation of congenital heart disease...
February 22, 2018: Radiology
Yohei Yamada, Ken Hoshino, Takayuki Oyanagi, Ryohei Gatayama, Jun Maeda, Nobuyuki Katori, Yasushi Fuchimoto, Taizo Hibi, Masahiro Shinoda, Kentaro Matsubara, Hideaki Obara, Ryo Aeba, Yuko Kitagawa, Hiroyuki Yamagishi, Tatsuo Kuroda
Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology...
February 19, 2018: Pediatric Transplantation
Lindsay A Edwards, Christine Bui, Antonio G Cabrera, Jill Ann Jarrell
OBJECTIVE: To improve outpatient advanced care planning (ACP) for adults with congenital/pediatric heart disease followed in a pediatric heart failure (HF) and transplant clinic through quality improvement (QI) methodology. DESIGN: A one-year QI project was completed. We conducted quarterly chart reviews and incorporated feedback from the providers to direct subsequent interventions. PATIENTS AND SETTING: Patients ≥18 years of age seen in the HF and Transplant Clinic for follow-up visit were included in analysis...
February 18, 2018: Congenital Heart Disease
Shi-Min Yuan
Pediatric cardiomyopathies are a group of myocardial diseases with complex taxonomies. Cardiomyopathy can occur in children at any age, and it is a common cause of heart failure and heart transplantation in children. The incidence of pediatric cardiomyopathy is increasing with time. They may be associated with variable comorbidities, which are most often arrhythmia, heart failure, and sudden death. Medical imaging technologies, including echocardiography, cardiac magnetic resonance, and nuclear cardiology, are helpful in reaching a diagnosis of cardiomyopathy...
January 31, 2018: Pediatrics and Neonatology
Christopher R Broda, Antonio G Cabrera, Joseph W Rossano, John L Jefferies, Jeffrey A Towbin, Clifford Chin, Pirouz Shamszad
BACKGROUND: The purpose of this study was to describe the prevalence, characteristics, and outcomes in pediatric patients with chromosomal anomalies (CA) undergoing orthotopic heart transplantation (OHT). METHODS: A query of the database of the Pediatric Health Information System, a large administrative and billing database of 43 tertiary children's hospitals, was performed for the Years 2004 to 2016. Pediatric patients who received OHT were analyzed based on presence and type of CA...
January 31, 2018: Journal of Heart and Lung Transplantation
Warren A Zuckerman, Adriana Zeevi, Kristen L Mason, Brian Feingold, Carol Bentlejewski, Linda J Addonizio, Elizabeth D Blume, Charles E Canter, Anne I Dipchand, Daphne T Hsu, Robert E Shaddy, William T Mahle, Anthony J Demetris, David M Briscoe, Thalachallour Mohanakumar, Joseph M Ahearn, David N Iklé, Brian D Armstrong, Yvonne Morrison, Helena Diop, Jonah Odim, Steven A Webber
Anti-HLA donor-specific antibodies are associated with worse outcomes following organ transplantation. Among sensitized pediatric heart candidates, requirement for negative donor-specific cytotoxicity crossmatch increases wait times and mortality. However, transplantation with positive crossmatch may increase post-transplant morbidity and mortality. We address this clinical challenge in a prospective, multi-center, observational cohort study of children listed for heart transplantation (CTOTC-04). Outcomes were compared among sensitized recipients who underwent transplant with positive crossmatch, non-sensitized recipients, and sensitized recipients without positive crossmatch...
February 15, 2018: American Journal of Transplantation
A I Dipchand, S Webber, K Mason, B Feingold, C Bentlejewski, W T Mahle, R Shaddy, C Canter, E D Blume, J Lamour, W Zuckerman, H Diop, Y Morrison, B Armstrong, D Ikle, J Odim, A Zeevi
Data on the clinical importance of newly detected donor specific antibodies (ndDSA) following pediatric heart transplantation is lacking despite mounting evidence of the detrimental effect of de novo DSA in solid organ transplantation. We prospectively tested 237 pediatric heart transplant recipients for ndDSA in the first year post-transplant in order to determine their incidence, pattern and clinical impact. One third of patients developed ndDSA; when present, these were mostly detected within the first 6 weeks after transplant suggesting that memory responses may predominate over true de novo DSA production in this population...
February 14, 2018: American Journal of Transplantation
Teresa Frey, Nofil Arain
Pediatric myocarditis is a common pediatric illness most commonly secondary to a preceding viral infection. It is a leading cause of acquired heart failure, cardiomyopathy, and cardiac transplantation in pediatrics. Due to the variability in presentation, the diagnosis is often unrecognized until later in the disease course. It should be considered in the differential diagnosis of all children presenting with respiratory distress, since this is the most common presentation. Imagining modalities, such as cardiac magnetic resonance imaging have become a useful diagnostic tool in recent years; however, endomyocardial biopsy remains the gold standard diagnostic test...
January 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Sabrina P Law, Assaf P Oron, Mariska S Kemna, Erin L Albers, D Michael McMullan, Jonathan M Chen, Yuk M Law
OBJECTIVES: Ventricular assist devices have gained popularity in the management of refractory heart failure in children listed for heart transplantation. Our primary aim was to compare the composite endpoint of all-cause pretransplant mortality and loss of transplant eligibility in children who were treated with a ventricular assist device versus a medically managed cohort. DESIGN: This was a retrospective cohort analysis. SETTINGS: Data were obtained from the Scientific Registry of Transplant Recipients...
February 12, 2018: Pediatric Critical Care Medicine
Jane W Newburger, Lynn A Sleeper, J William Gaynor, Danielle Hollenbeck-Pringle, Peter C Frommelt, Jennifer S Li, William T Mahle, Ismee A Williams, Andrew M Atz, Kristin M Burns, Shan Chen, James Cnota, Carolyn Dunbar-Masterson, Nancy S Ghanayem, Caren S Goldberg, Jeffrey P Jacobs, Alan B Lewis, Seema Mital, Christian Pizarro, Aaron Eckhauser, Paul Stark, Richard G Ohye
Background -In the Single Ventricle Reconstruction (SVR) trial, one-year transplant-free survival was better for the Norwood procedure with right ventricle-to-pulmonary artery shunt (RVPAS) compared with a modified Blalock-Taussig shunt (MBTS) in patients with hypoplastic left heart and related syndromes. At 6 years, we compared transplant-free survival and other outcomes between the groups. Methods -Medical history was collected annually using medical record review, telephone interviews, and the death index...
February 1, 2018: Circulation
Chesney D Castleberry, John L Jefferies, Ling Shi, James D Wilkinson, Jeffrey A Towbin, Ryan W Harrison, Joseph W Rossano, Elfriede Pahl, Teresa M Lee, Linda J Addonizio, Melanie D Everitt, Justin Godown, Joseph Mahgerefteh, Paolo Rusconi, Charles E Canter, Steven D Colan, Paul F Kantor, Hiedy Razoky, Steven E Lipshultz, Tracie L Miller
OBJECTIVES: This study aimed to examine the role of nutrition in pediatric dilated cardiomyopathy (DCM). BACKGROUND: In adults with DCM, malnutrition is associated with mortality, whereas obesity is associated with survival. METHODS: The National Heart, Lung, and Blood Institute-funded Pediatric Cardiomyopathy Registry was used to identify patients with DCM and categorized by anthropometric measurements: malnourished (MN) (body mass index [BMI] <5% for ≥2 years or weight-for-length <5% for <2 years), obesity (BMI >95% for age ≥2 years or weight-for-length >95% for <2 years), or normal bodyweight (NB)...
February 1, 2018: JACC. Heart Failure
Katsuhide Maeda, David N Rosenthal, Olaf Reinhartz
Heart transplant waitlist survival in pediatric patients has been substantially improved since the introduction of pediatric-specific ventricular assist device. In neonates and infants, however, the waitlist mortality remains very high. The only long-term device currently approved for use in the United States is the Berlin Heart EXCOR, but this device has several important limitations because of the paracorporeal, pulsatile nature of the underlying technology. We reviewed Stanford ventricular assist experience on patients less than 1 year old since 2004...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Hugo R Martinez, Samuel Wittekind, Roosevelt Bryant, James S Tweddell, Clifford Chin
The objective of this study is to describe identifiable risk factors, complications, and pitfalls while listing pediatric patients for heart transplantation, which is the standard of care for end-stage heart disease in children. Since the introduction of cyclosporine in the 1980s, the management in pediatric heart transplantation has shown consistent improvement, mainly because of technological advances and the integration of multidisciplinary teams in the field. However, the complexity of this patient population makes medical providers vulnerable to complications as a result of undesirable mistakes...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
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