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Pediatric heart transplantation

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https://www.readbyqxmd.com/read/29240626/first-report-of-biventricular-percutaneous-impella-ventricular-assist-device-use-in-pediatric-patients
#1
Javier J Lasa, Daniel A Castellanos, Susan W Denfield, William J Dreyer, Sebastian C Tume, Henri Justino, Athar M Qureshi
There is a growing interest in the use of percutaneously delivered ventricular assist devices (PVAD) in the pediatric patient population. A 16 year old female and 18 year old male both status post heart transplantation presented with evidence of graft rejection and acute severe global systolic and diastolic heart failure necessitating hemodynamic catheterization and inotropic support. Both underwent percutaneous Impella CP LVAD (Abiomed, Danvers, MA) placement with close monitoring of right ventricular function...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29230826/evolution-of-biventricular-loading-condition-in-pediatric-lvad-patient-a-prospective-and-observational-study
#2
Arianna Di Molfetta, Roberta Iacobelli, Sergio Filippelli, Giorgia Grutter, Gianluigi Perri, Francesca Iodice, Luciano Pasquini, Paolo Guccione, Antonio Amodeo
The aim of this study was to describe the echocardiographic trend of left ventricular (LV) and right ventricular (RV) function after implantation of a pulsatile flow left ventricular assist device (LVAD) in children. From 2013 to 2016, we prospectively evaluated 13 consecutive pediatric Berlin Heart EXCOR LVAD patients. Clinical and echocardiographic data were collected at baseline, within 24 h after implantation and monthly until LVAD explant. Median age and weight at the implantation was 8 (4-23) months and 5 (4...
December 12, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29226563/fatal-cardiac-arrest-in-pediatric-heart-transplant-recipients-query-of-the-unos-database
#3
Robert W Loar, Susan W Denfield, Shaine A Morris, Hari P Tunuguntla, Antonio G Cabrera, Jack F Price, Wei Zhang, Katherine Hosek, Jeffrey J Kim, William J Dreyer, Aamir Jeewa
The incidence of death by CA after PHTx is unknown. We aimed to determine the incidence and factors for fatal CA after PHTx, and whether a PM affects survival. Retrospective cohort study utilizing the United Network of Organ Sharing registry of patients transplanted ≤18 years. Multivariable analyses in hazard-function domain and Kaplan-Meier analyses were performed for an outcome of death due to CA. There were 7719 PHTx patients queried. CA was the reported cause of death in 11%. Age ≥13 years at time of transplant, presence of a PM, and depressed EF were identified as significant factors for fatal CA...
December 10, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29223439/a-unique-linkage-of-administrative-and-clinical-registry-databases-to-expand-analytic-possibilities-in-pediatric-heart-transplantation-research
#4
Justin Godown, Cary Thurm, Debra A Dodd, Jonathan H Soslow, Brian Feingold, Andrew H Smith, Bret A Mettler, Bryn Thompson, Matt Hall
BACKGROUND: Large clinical, research, and administrative databases are increasingly utilized to facilitate pediatric heart transplant (HTx) research. Linking databases has proven to be a robust strategy across multiple disciplines to expand the possible analyses that can be performed while leveraging the strengths of each dataset. We describe a unique linkage of the Scientific Registry of Transplant Recipients (SRTR) database and the Pediatric Health Information System (PHIS) administrative database to provide a platform to assess resource utilization in pediatric HTx...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223416/cost-variation-across-centers-for-the-norwood-operation
#5
Kimberly E McHugh, Sara K Pasquali, Matthew A Hall, Mark A Scheurer
BACKGROUND: The Norwood operation is associated with high health care utilization, and prior studies reported substantial variability in Norwood costs across centers. However, specific factors driving this cost variation are unclear. We assessed center variability in Norwood costs and underlying mechanisms in a multicenter cohort. METHODS: Clinical data from the Pediatric Heart Network Single Ventricle Reconstruction trial were linked with cost data from the Children's Hospital Association Inpatient Essentials database...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29222866/outcome-of-antibody-mediated-rejection-compared-to-acute-cellular-rejection-after-pediatric-heart-transplantation
#6
Gabrielle R Vaughn, Neal W Jorgensen, Yuk M Law, Erin L Albers, Borah J Hong, Joshua M Friedland-Little, Mariska S Kemna
Outcomes of ACR after pediatric HTx have been well described, but less has been reported on outcomes of AMR. We compared the clinical characteristics and cardiovascular outcomes (composite end-point of death, retransplantation, or allograft vasculopathy) of pediatric HTx recipients with AMR, ACR, and no rejection in a retrospective single-center study of 104 recipients. Twenty were treated for AMR; 15 were treated for ACR. Recipients with AMR had an increased frequency of congenital heart disease (90% vs ACR 67% vs no rejection 59%, P = ...
December 9, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29222858/obesity-lipid-profiles-and-oxidative-stress-in-children-after-liver-transplantation
#7
Piotr Czubkowski, Aldona Wierzbicka, Joanna Pawłowska, Irena Jankowska, Piotr Socha
PURPOSE: In adult liver transplant recipients, coronary artery disease and congestive heart failure are significant cause of morbidity and mortality. This may be attributed to the long-term immunosuppressive treatment, mostly with calcineurin inhibitors and steroids, which in long-term may be associated with hyperlipidemia, oxidative stress and cardiovascular complications. Since such data for children is sparse, the aim of this study was to assess the lipid and oxidative stress markers after pediatric liver transplantation (LTx)...
December 10, 2017: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/29217110/end-stage-renal-disease-after-pediatric-heart-transplantation-a-25-year-national-cohort-study
#8
EDITORIAL
Estela Azeka
No abstract text is available yet for this article.
November 15, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29210159/safety-of-mtor-inhibitor-continuation-in-pediatric-heart-transplant-recipients-undergoing-surgical-procedures
#9
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
December 6, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29189669/measurement-of-dead-space-fraction-upon-icu-admission-predicts-length-of-stay-and-clinical-outcomes-following-bidirectional-cavopulmonary-anastomosis
#10
Claire L Cigarroa, Sarah J van den Bosch, Xiaoqi Tang, Kimberlee Gauvreau, Christopher W Baird, James A DiNardo, John Nagi Kheir
OBJECTIVES: Increased alveolar dead space fraction has been associated with prolonged mechanical ventilation and increased mortality in pediatric patients with respiratory failure. The association of alveolar dead space fraction with clinical outcomes in patients undergoing bidirectional cavopulmonary anastomosis for single ventricle congenital heart disease has not been reported. We describe an association of alveolar dead space fraction with postoperative outcomes in patients undergoing bidirectional cavopulmonary anastomosis...
November 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189424/iphone-in-the-management-of-the-berlin-heart-excor-ventricular-assist-device
#11
Aditya Badheka, Veerajalandhar Allareddy
Berlin Heart Inc. EXCOR is an extracorporeal pneumatically pulsatile ventricular assist device approved for use in pediatric age group since 2011 in the United States. It is a well-established life-saving therapy for the bridge to heart transplant or to provide circulatory support in a transplanted patient. The most commonly reported problem was "membrane defect" in a postmarketing major device reporting. In general, the filling and emptying of the pump can be easily visualized, but the interobserver variability exist...
November 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29189423/the-boy-in-the-bubble-and-the-baby-with-the-berlin-heart-the-dangers-of-bridge-to-decision-in-pediatric-mechanical-circulatory-support
#12
Seth A Hollander, Ethan J Hollander
On the day of his birth in 1971, David Vetter was "temporarily" placed in a sterile isolator to wait for a bone marrow donor who would cure his Severe Combined Immunodeficiency Syndrome. After enduring 12 years in isolation, David, now known to the world as "The Boy in the Bubble", received a bone marrow transplant from his unmatched sister and died 4 months later. Like Severe Combined Immunodeficiency Syndrome, pediatric heart failure is a rare and life-threatening condition for which organ transplantation is often the only option for survival...
November 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29174220/outcomes-of-children-supported-with-devices-labeled-as-temporary-or-short-term-a-report-from-the-pediatric-interagency-registry-for-mechanical-circulatory-support
#13
Angela Lorts, Pirooz Eghtesady, Mary Mehegan, Iki Adachi, Chet Villa, Ryan Davies, Jeffrey G Gossett, Kirk Kanter, Juan Alejos, Devin Koehl, Ryan S Cantor, David L S Morales
BACKGROUND: Historically, the "temporary" or short-term ventricular assist device (VAD) was used only as a quick bridge to recovery for children with an acute process. In the current era, the devices that were originally used for temporary support are now being used to support children for longer durations and for a variety of indications. In this study we aimed to describe the overall use, patients' characteristics and outcomes of "temporary" VAD use in children. METHODS: The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a National Institutes of Health-supported national registry for United States Food and Drug Administration-approved VADs in patients <19 years of age at the time of VAD implantation (either durable or temporary VAD)...
October 31, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29169474/survival-without-cardiac-transplantation-among-children-with-dilated%C3%A2-cardiomyopathy
#14
Rakesh K Singh, Charles E Canter, Ling Shi, Steven D Colan, Debra A Dodd, Melanie D Everitt, Daphne T Hsu, John L Jefferies, Paul F Kantor, Elfriede Pahl, Joseph W Rossano, Jeffrey A Towbin, James D Wilkinson, Steven E Lipshultz
BACKGROUND: Studies of children with dilated cardiomyopathy (DCM) have suggested that improved survival has been primarily due to utilization of heart transplantation. OBJECTIVES: This study sought to determine transplant-free survival for these children over 20 years and identify the clinical characteristics at diagnosis that predicted death. METHODS: Children <18 years of age with some type of DCM enrolled in the Pediatric Cardiomyopathy Registry were divided by year of diagnosis into an early cohort (1990 to 1999) and a late cohort (2000 to 2009)...
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29168549/first-polish-analysis-of-the-treatment-of-advanced-heart-failure-in-children-with-the-use-of-berlinheart-excor-mechanical-circulatory-support
#15
Szymon Pawlak, Roman Przybylski, Janusz Skalski, Joanna Śliwka, Andrzej Kansy, Adam Grzybowski, Arkadiusz Wierzyk, Jacek Białkowski, Bohdan Maruszewski, Marian Zembala
BACKGROUND: The treatment of advanced heart failure in children and infants poses a serious management problem. Heart failure in that patient group is usually of congenital etiology. The treatment schedules for pediatric patients are in most cases adapted from the guidelines for treatment of adults. Up to 2009, the treatment of that extremely difficult group of patients was limited to pharmacological therapy and occasional heart transplantations. Constantly increasing problems with recruiting donors, especially for the pediatric group, contribute to the fact that mechanical support with the use of ventricular assist devices is for many children the only chance to survive the period of waiting for a heart donor...
November 23, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29157741/biventricular-support-with-intracorporeal-continuous-flow-centrifugal-ventricular-assist-devices
#16
Francisco A Arabía, Carmelo A Milano, Claudius Mahr, Edwin C McGee, Nahush A Mokadam, J Eduardo Rame, Jaime D Moriguchi, Danny Ramzy, David C Naftel, Susan L Myers, James K Kirklin
BACKGROUND: The incidence of right ventricular dysfunction requiring right ventricular assist device after left ventricular assist device placement has been reported between 10% to 30%. The mortality rate is higher compared with patients who require left ventricular assist device only; the most effective and safest biventricular assist device remains unknown. We aimed to determine the survival outcomes and frequency of adverse events in patients with two durable, intracorporeal, continuous flow centrifugal pumps for support...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29154821/heterotaxy-syndrome-and-associated-arrhythmias-in-pediatric-patients
#17
Mary C Niu, Heather A Dickerson, Judson A Moore, Caridad de la Uz, Santiago O Valdés, Jeffrey J Kim, David E Bard, Shaine A Morris, Christina Y Miyake
BACKGROUND: Heterotaxy Syndrome (HS) is a rare disorder with complex anatomy involving misarrangements of the cardiac conduction system. Arrhythmias may be related to anatomic variations and contribute to morbidity. OBJECTIVE: This study investigated the associations between arrhythmias, anatomy, and outcomes in a large HS cohort. METHODS: A single center retrospective review of patients diagnosed with HS ≤ 21 years of age was performed...
November 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29147800/the-pediatric-heart-failure-workforce-an-international-multicenter-survey
#18
Scott R Auerbach, Melanie D Everitt, Ryan J Butts, David N Rosenthal, Yuk M Law
Our objective was to understand the scope of pediatric heart failure (HF) and the current staffing environment of HF programs. An online survey was distributed to members of the Pediatric Heart Transplant Study and the Pediatric Council of the International Society for Heart and Lung Transplantation. All participants received the primary 23-question survey. Additionally, HF program directors received a 32-question supplemental survey. Of 235 invitations sent, there were 69 (29%) primary surveys and 34 program director surveys completed (24 U...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29144053/the-impact-of-flow-pra-on-outcome-in-pediatric-heart-recipients-in-modern-era-an-analysis-of-the-pediatric-heart-transplant-study-database
#19
B B Das, E Pruitt, K Molina, W Ravekes, S Auerbach, A Savage, L Knox, J K Kirklin, D C Naftel, D Hsu
Data from patients in the Pediatric Heart Transplant Study (PHTS) registry transplanted between 2010 and 2014 were analyzed to determine the association between HLA antibody (PRA) determined by SPA using Luminex or flow cytometry with a positive retrospective cross-match and the post-transplant outcomes of acute rejection and graft survival. A total of 1459 of 1596 (91%) recipients had a PRA reported pretransplant; 26% had a PRA > 20%. Patients with a PRA > 20% were more likely to have CHD, prior cardiac surgery, ECMO support at listing, and waited longer for transplantation than patients with a PRA <20%...
November 16, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29131462/outcomes-of-liver-transplantation-in-pediatric-recipients-with-cardiovascular-disease
#20
Márcio Miranda Brito, Joao Seda Neto, Eduardo A Fonseca, Renata Pugliese, Vera B Danesi, Helry L Candido, Adriana Porta, Cristian V B Borges, Gilda Porta, Paulo Chapchap, Irene Kazue Miura
LT exerts considerable stress on the heart perioperatively. Limited data exist on impact of cardiovascular diseases on LT children. This study evaluated the outcomes of children with CVD who underwent LT and compared with pretransplant findings. From 518 LT recipients, 82 (15.8%) had CVD. Sixty patients were classified as low-risk adjustment for congenital heart surgery 1 (RACHS 1 and 2). Five patients were classified as RACHS ≥3. The most common echocardiographic finding in the CVD patients (25/82) was ASD...
November 12, 2017: Pediatric Transplantation
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