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Pediatric heart transplantation

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https://www.readbyqxmd.com/read/29684375/cumulative-effect-of-preoperative-risk-factors-on-mortality-after-pediatric-heart-transplantation
#1
Matthew J O'Connor, Andrew C Glatz, Joseph W Rossano, Robert E Shaddy, Rachel Ryan, Chitra Ravishankar, Stephanie Fuller, Christopher E Mascio, J William Gaynor, Kimberly Y Lin
BACKGROUND: Risk assessment in heart transplantation is critical for candidate selection, but current models inadequately assess individual risk of postoperative mortality. We sought to identify risk factors and develop a scoring system to predict mortality following heart transplantation in children. METHODS: The records of patients undergoing heart transplantation at our institution from 2010 - 2016 were reviewed. Clinical characteristics were recorded and compared between survivors and non-survivors...
April 20, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29677081/changes-in-pediatric-heart-transplant-hospitalization-costs-over-time
#2
Justin Godown, Cary Thurm, Matt Hall, Jonathan H Soslow, Brian Feingold, Bret A Mettler, Andrew H Smith, David W Bearl, Debra A Dodd
BACKGROUND: Despite significant changes in the past decade for children undergoing heart-transplantation, including the evolution of mechanical circulatory support and increasing patient complexity, costs and resource utilization have not been reassessed. We sought to utilize a novel linkage of clinical-registry and administrative data to examine changes in hospitalization costs over time in this population. METHODS: We identified all pediatric heart transplant recipients in a unique linked PHIS/SRTR dataset (2002-2016)...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29673058/pediatric-heart-transplantation-across-a-positive-crossmatch-first-year-results-from-the-ctotc-04-multi-institutional-study
#3
S Webber, A Zeevi, K Mason, L Addonizio, E Blume, A Dipchand, R Shaddy, B Feingold, C Canter, D Hsu, W Mahle, B Armstrong, Y Morrison, D Ikle, H Diop, J Odim
Sensitization is common in pediatric heart transplant candidates and wait list mortality is high. Transplantation across a positive crossmatch may reduce wait time, but is considered high risk. We prospectively recruited consecutive candidates at 8 North American centers. At transplantation, subjects were categorized as non-sensitized or sensitized (presence of ≥1 HLA antibody with MFI ≥1,000 using single antigen beads). Sensitized subjects were further classified as CDC-crossmatch positive or negative and as DSA positive or negative...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29668027/heart-transplant-in-children-what-a-primary-care-provider-needs-to-know
#4
Swati Sehgal, Emily Shea, Lauren Kelm, Deepak Kamat
Heart transplantation is offered to children with heart failure that is not amenable to medical or surgical therapy. Indications for heart transplant include unrepairable congenital heart disease, failed palliation of congenital heart disease, and cardiomyopathies. There has been tremendous progress in this field since the first heart transplant was performed in 1967. Each year, approximately 500 pediatric heart transplants take place worldwide. Pediatric heart transplant survivors are living longer with their initial transplant...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29667250/a-new-2d-echocardiographic-approach-to-evaluate-the-membrane-and-valve-movement-of-the-berlin-heart-excor-vad-chamber-in-pediatric-vad-patients
#5
Arianna Di Molfetta, Roberta Iacobelli, Gianfranco Ferrari, Sergio Filippelli, Gianluigi Perri, Alessandra Toscano, Rachele Adorisio, Paolo Guccione, Antonio Amodeo
The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and its interaction with the native heart in a pediatric population. ECHO evaluation of BH membrane movement, and inflow and outflow valves was performed in 2D, 2D-color Doppler, M-mode, and M-mode color Doppler to assess the functioning of the device by direct positioning of the ECHO probe on the BH cannulas and membranes...
April 2018: Artificial Organs
https://www.readbyqxmd.com/read/29664507/echocardiographic-evaluation-after-pediatric-heart-transplant-in-chile-initial-application-of-a-functional-protocol-with-global-longitudinal-strain
#6
Claudia Trincado, Víctor Molina, Gonzalo Urcelay, Paulina Dellepiane
INTRODUCTION: The echocardiographic evaluation of patients after heart transplantation is a useful tool. However, it is still necessary to define an optimal follow-up protocol. OBJECTIVE: To describe the results of the application of a functional echocardiographic protocol in patients being followed after pediatric heart transplantation. PATIENTS AND METHOD: Alls patients being followed at our institution after pediatric heart transplantation underwent an echocardiographic examination with a functional protocol that included global longitudinal strain...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29650343/safety-efficacy-and-management-of-subcutaneous-treprostinil-infusions-in-the-treatment-of-severe-pediatric-pulmonary-hypertension
#7
Marilyne Levy, Maria-Jesus Del Cerro, Sophie Nadaud, Karunakar Vadlamudi, Elizabeth Colgazier, Jeff Fineman, Damien Bonnet, Ian Adatia
BACKGROUND: Continuous intravenous epoprostenol was the first treatment approved for pulmonary arterial hypertension (PAH) but administration through a central venous line carries risks of thrombosis and sepsis, particularly in children. We sought to evaluate the safety, efficacy and management of subcutaneous (SC) treprostinil in children with PAH. METHODS: Fifty-six children (median age 65, range 1-200 months) were treated with SC treprostinil. Clinical status, echocardiography, NT-proBNP, and site pain and infection were evaluated...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29642499/cimetidine-a-safe-treatment-option-for-cutaneous-warts-in-pediatric-heart-transplant-recipients
#8
Bibhuti B Das, Kristin Anton, Nelia Soares, Susan Riojas, Jodi Mcdermott, Leah Knox, Susan Daneman, Bao N Puente
Abstract : Background and Objectives : Immunosuppressed individuals are at particularly increased risk for human papilloma virus-related infections. The primary objective of our study is to determine if there are any adverse effects associated with high-dose cimetidine treatment. A secondary objective is to report our experience with cimetidine in the treatment of cutaneous warts in pediatric heart transplant recipients. Methods and Results : This was a retrospective observational study. A total of 8 pediatric heart transplant recipients diagnosed with multiple recalcitrant warts were the subject of the study...
April 8, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29607544/outcome-of-pediatric-heart-transplantation-in-blood-culture-positive-donors-in-the-united-states
#9
Shahnawaz M Amdani, Wei Du, Sanjeev Aggarwal
Active donor infection at time of organ procurement poses a potential infection risk and may increase post-transplant morbidity and mortality in recipients. Our hypothesis was that pediatric heart transplant recipients from blood culture positive donors (BCPD) would have increased morbidity and mortality compared to non-blood culture positive donors (NBCPD). A retrospective analyses of pediatric heart transplant recipients using the Organ Procurement and Transplant Network (OPTN) between 1987 and 2015 were conducted...
April 1, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29602613/noninvasive-echocardiographic-measures-of-pulmonary-vascular-resistance-in-children-and-young-adults-with-cardiomyopathy
#10
Dor Markush, Robert D Ross, Ronald Thomas, Sanjeev Aggarwal
BACKGROUND: Patients with cardiomyopathy (CM) are at increased risk for pulmonary hypertension (PH). Data are lacking on the use of noninvasive PH measures by echocardiography in patients with CM. The aim of this study was to evaluate the correlation between Doppler-derived echocardiographic indices and catheterization-based measurement of pulmonary vascular resistance (PVR) in children and young adults with CM. METHODS: Imaging studies were retrospectively reviewed from pediatric patients with CM who underwent both echocardiography and cardiac catheterization within a 72-hour period...
March 27, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29587521/orthotopic-heart-transplantation-in-children
#11
Nagarajan Muthialu
Heart transplantation is a relatively infrequent but technically demanding procedure in pediatric cardiac surgery. Orthotopic heart transplantation is often offered to older children or adolescents following multiple previous operations, but with advances in intensive care, diagnostics, and management, more infants with complex congenital heart diseases are being listed for transplantation. Primary cardiomyopathies remain the most common indication. Outcomes following cardiothoracic transplantation have improved steadily in recent times...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29580908/-extracorporeal-life-support-and-heart-lung-transplant-in-children
#12
Sébastien Hascoet, Angèle Boet, Karine Nubret, Marc Lilot, Séverine Feuillet, Nadir Benbrik, Julien Guihaire, Emmanuel Le Bret, Elie Fadel, Virginie Fouilloux, Pascal Amedro, Lucile Houyel, Bernard Kreitmann
Extracorporeal life support and heart and/or lung transplant are the last resort in children with end-stage cardiac and/or pulmonary failure and short-term life threaten. Currently, circulatory support is used as a bridge to recovery or as a bridge to transplant but not as a destination therapy. The Excor Berlin Heart is the long-lasting external pneumatic ventricular assist system that is currently available from infancy to adulthood. Long-term prognosis after pediatric cardiac and/or pulmonary transplant is conditioned by the occurrence of graft failure, coronary disease of the cardiac graft, viral infections and bronchiolitis obliterans of the pulmonary graft, the incidence of which increase with time...
March 23, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29575396/changes-in-left-ventricular-strain-parameters-following-pediatric-heart-transplantation
#13
Justin Godown, Debra A Dodd, Michael Stanley, Corey Havens, Meng Xu, James C Slaughter, David W Bearl, Jonathan H Soslow
STE is increasingly utilized to assess strain in a variety of pathologies. Strain measurements have demonstrated utility following HTx and may aid in the detection of rejection and CAV. Strain parameters have not been well defined in the pediatric HTx population. This study aimed to describe strain in pediatric HTx recipients compared to controls and assess changes over time. All pediatric HTx recipients with available echocardiograms (2004-2015) without rejection or CAV were identified. Longitudinal and circumferential strain was measured at <1 month, 1 year, 3 years, and 5 years post-transplant and compared to controls...
March 25, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29571602/heart-failure-after-the-norwood-procedure-an-analysis-of-the-single-ventricle-reconstruction-trial
#14
William T Mahle, Chenwei Hu, Felicia Trachtenberg, JonDavid Menteer, Steven J Kindel, Anne I Dipchand, Marc E Richmond, Kevin P Daly, Heather T Henderson, Kimberly Y Lin, Michael McCulloch, Ashwin K Lal, Kurt R Schumacher, Jeffrey P Jacobs, Andrew M Atz, Chet R Villa, Kristin M Burns, Jane W Newburger
BACKGROUND: Heart failure results in significant morbidity and mortality in young children with hypoplastic left heart syndrome (HLHS) after the Norwood procedure. METHODS: We studied subjects enrolled in the prospective Single Ventricle Reconstruction (SVR) Trial who survived to hospital discharge after a Norwood operation and were followed up to age 6 years. The primary outcome was heart failure, defined as heart transplant listing after Norwood hospitalization, death attributable to heart failure, or symptomatic heart failure (New York Heart Association [NYHA] Class IV)...
February 16, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29564593/advances-in-heart-failure-therapy-in-pediatric-patients-with-dilated-cardiomyopathy
#15
REVIEW
Stefan Rupp, Christian Jux
While in adults major advances in heart failure therapy in patients with dilated cardiomyopathy were documented in the last two decades, research on the mechanism and therapies of heart failure in children with left ventricular dilated cardiomyopathy has lagged behind. Despite the lack of sufficient randomized prospective studies, ACE inhibitors are first line and ß-receptor antagonists are second-line strategies in children. Following the adult guidelines, without having data concerning the pediatric population, mineral corticoids are also accepted in the treatment of pediatric heart failure, while diuretics should only be used to achieve a euvolemic status...
March 22, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29558879/geographic-distance-from-transplant-center-does-not-impact-pediatric-heart-transplant-outcomes
#16
Meghann McKane, Debra A Dodd, Bret A Mettler, Kari A Wujcik, Justin Godown
BACKGROUND: Many pediatric heart transplant recipients live a significant distance from their transplant center. This results in families either traveling long distances or relying on outside physicians to assume aspects of their care. Distance has been implicated to play a role in congenital heart disease outcomes, but its impact on heart transplantation has not been reported. The aim of this study was to assess the impact of distance on pediatric heart transplant outcomes. METHODS: The Scientific Registry of Transplant Recipients database was queried for all pediatric heart transplant recipients from large US children's hospitals (1987-2014)...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29557615/-tolvaptan-in-a-pediatric-cardiorenal-syndrome-what-is-its-role
#17
M Angeles Tejero Hernández, Elena García Martínez, M José Arroyo Marin, Elena Gómez Guzmán
The cardiorenal syndrome has been defined as a situation in which therapy to relieve congestive symptoms of heart failure is limited by a decreased renal function. The resistance to conventional diuretic treatment makes difficult managing these patients. Tolvaptan, a selective vasopressin-2 receptor antagonist, has been used successfully in adults with this pathology but the experience with children is very limited. A five-year-old girl with renal failure waiting for a heart transplant is presented. Tolvaptan (0...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29552945/predictors-of-poor-outcomes-in-pediatric-venoarterial-extracorporeal-membrane-oxygenation
#18
Maanasi S Mistry, Sara M Trucco, Timothy Maul, Mahesh S Sharma, Li Wang, Shawn West
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides respiratory and hemodynamic support to pediatric patients in severe cardiac failure. We aim to identify risk factors associated with poorer outcomes in this population. METHODS: A retrospective chart review was conducted of pediatric patients requiring VA-ECMO support for cardiac indications at our institution from 2004 to 2015. Data were collected on demographics, indication, markers of cardiac output, ventricular assist device (VAD) insertion, heart transplantation, or left atrial (LA) decompression...
January 1, 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29551744/world-wide-experience-of-a-durable-centrifugal-flow-pump-in-pediatric-patients
#19
J Conway, O Miera, I Adachi, K Maeda, P Eghtesady, H T Henderson, K Guleserian, C-P S Fan, R Kirk
OBJECTIVES: The primary objectives of this study were to describe the characteristics and survival outcomes for children supported with the HeartWare HVAD® system from the global community. METHODS: This was a retrospective survey of patients <18 years with a HVAD® system. Questionnaires were sent to sites across the world in April 2015 and collected between May 2015-16. Information on 205 patients was collected. RESULTS: The median age of implant was 13...
March 15, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29550149/ishlt-consensus-statement-on-adult-and-pediatric-airway-complications-after-lung-transplantation-definitions-grading-system-and-therapeutics
#20
EDITORIAL
Maria M Crespo, Daniel P McCarthy, Peter M Hopkins, Stephen C Clark, Marie Budev, Christian A Bermudez, Christian Benden, Pirooz Eghtesady, Erika D Lease, Lorriana Leard, Jonathan D'Cunha, Christopher H Wigfield, Marcelo Cypel, Joshua M Diamond, James J Yun, Lonny Yarmus, Michael Machuzak, Walter Klepetko, Geert Verleden, Konrad Hoetzenecker, Göran Dellgren, Michael Mulligan
Airway complications remain a major cause of morbidity and mortality after cardiothoracic transplantation. The reported incidence of airway ischemic complications varies widely, contributed to by the lack of a universally accepted grading system and standardized definitions. Furthermore, the majority of the existing classification systems fail to integrate the wide range of possible bronchial complications that may develop after lung transplant. Hence, a Working Group was created by the International Society for Heart and Lung Transplantation with the aim of elaborating a universal definition of adult and pediatric airway complications and grading system...
February 7, 2018: Journal of Heart and Lung Transplantation
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