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Pediatric heart transplantation

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https://www.readbyqxmd.com/read/28332766/the-effects-of-center-volume-on-mortality-in-pediatric-heart-transplantation-the-rest-of-the-story
#1
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
#2
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
#3
Andrew J Redmann, John C Bucuvalas, Robert E Wood, Clifford Chin, Catherine K Hart
OBJECTIVES: 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 Ebstein 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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28280632/ebv-associated-hepatic-smooth-muscle-tumor-of-uncertain-biologic-behavior-after-heart-transplantation-in-a-pediatric-patient-case-report
#8
Yan Liu, Suneetha Chintalapati, Robin Dietz, Adnan S Raza, Jun Wang, Anwar Sultana Raza
Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare neoplasm recognized in immunocompromised patients. There are less than 30 cases of EBV-SMT reported in pediatric population following solid organ transplantation. Herein, we report a case of an 8-year-old female who was incidentally noted to have multiple lesions in the liver 8 years after heart transplantation. The tumor was composed of a cellular proliferation of spindle-shaped cells with low mitotic activity. The diagnosis of EBV-SMT was confirmed by in situ hybridization for EBV-encoded small RNA (EBER) transcripts...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28279666/pediatric-heart-failure-a-practical-guide-to-diagnosis-and-management
#9
REVIEW
Daniele Masarone, Fabio Valente, Marta Rubino, Rossella Vastarella, Rita Gravino, Alessandra Rea, Maria Giovanna Russo, Giuseppe Pacileo, Giuseppe Limongelli
Pediatric heart failure represents an important cause of morbidity and mortality in childhood. Currently, there are well-established guidelines for the management of heart failure in the adult population, but an equivalent consensus in children is lacking. In the clinical setting, ensuring an accurate diagnosis and defining etiology is essential to optimal treatment. Diuretics and angiotensin-converting enzyme inhibition are the first-line therapies, whereas beta-blockers and devices for electric therapy are less used in children than in adults...
February 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28274556/comparison-of-right-ventricle-pulmonary-artery-shunt-position-in-the-single-ventricle-reconstruction-trial
#10
Nicholas D Andersen, James M Meza, Matthew R Byler, Andrew J Lodge, Kevin D Hill, Christoph P Hornik, Robert D B Jaquiss
OBJECTIVE: Placement of a right ventricle-pulmonary artery shunt to the left or right of the neoaorta may influence reinterventions, pulmonary artery development, and survival after the Norwood procedure because of differences in shunt and pulmonary artery geometry and blood flow. METHODS: We analyzed the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset. Comparisons were made between patients who received a left- or right-sided right ventricle-pulmonary artery shunt during the Norwood procedure in both the overall (n = 274) and the propensity score-matched (67 pairs) patient cohorts...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28267897/outcomes-of-pediatric-kidney-transplantation-in-recipients-of-a-previous-non-renal-solid-organ-transplant
#11
Gilad Hamdani, Bin Zhang, Chunyan Liu, Jens Goebel, Yue Zhang, Edward Nehus
Children who receive a non-renal solid organ transplant may develop secondary renal failure requiring kidney transplantation. We investigated outcomes of 165 pediatric kidney transplant recipients who previously received a heart, lung, or liver transplant using data from 1988-2012 reported to the United Network for Organ Sharing. Patient and allograft survival were compared with 330 matched primary kidney transplant (PKT) recipients. Kidney transplantation after solid organ transplant (KASOT) recipients experienced similar allograft survival: 5 and 10-year graft survival was 78% and 60% in KASOT recipients, compared to 80% and 61% in PKT recipients (p=0...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28264859/physical-activity-and-sedentary-behavior-in-children-with-congenital-heart-disease
#12
Christine Voss, Stephanie L Duncombe, Paige H Dean, Astrid M de Souza, Kevin C Harris
BACKGROUND: Children with congenital heart disease (CHD) are thought to have low levels of physical activity (PA), but few studies have used objective measures of PA in this population. METHODS AND RESULTS: We recruited patients with mild, moderate, and severe CHD and cardiac transplant recipients, aged 8 to 19 years, from pediatric cardiology clinics throughout British Columbia and Yukon, Canada. Participants were fitted with an ActiGraph accelerometer to be worn over the right hip for 7 days...
March 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28260473/perioperative-venoarterial-extracorporeal-membrane-oxygenation-support-during-heart-transplant
#13
Ender Gedik, Funda Atar, Aycan Ozdemirkan, Aynur Camkiran Firat, Pinar Zeyneloglu, Atilla Sezgin, Arash Pirat
OBJECTIVES: Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. This technique may be used after heart transplant for conditions refractory to medical treatment like primary graft failure. Previously, we reported our experience with patients who received extracorporeal support as a bridge to emergency heart transplant. In this study, we present our perioperative experience with heart transplants in which extracorporeal support was used...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28259596/berlin-heart-excor-use-in-patients-with-congenital-heart-disease
#14
David L S Morales, Farhan Zafar, Christopher S Almond, Charles Canter, Francis Fynn-Thompson, Jennifer Conway, Iki Adachi, Angela Lorts
BACKGROUND: Management of mechanical circulatory support in children with congenital heart disease (CHD) is challenging due to physiologic variations and anatomic limitations to device placement. In this study we examine the use of Berlin Heart EXCOR in CHD patients. METHODS: CHD patients were identified from the EXCOR Pediatric Study data set (2007 to 2010). Mortality and serious adverse events were compared between CHD and non-CHD cohorts, and predictors of poor outcomes in the CHD cohort were identified...
February 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28251816/inferior-outcomes-on-the-waiting-list-in-low-volume-pediatric-heart-transplant-centers
#15
Abbas Rana, Charles D Fraser, Brandi B Scully, Jeffrey S Heinle, E Dean McKenzie, William J Dreyer, Michael Kueht, Hao Liu, Eileen D Brewer, Todd K Rosengart, Christine A O'Mahony, John A Goss
Low case volume has been associated with poor outcomes in a wide spectrum of procedures. Our objective is to study the association of low case volume and worse outcomes in pediatric heart transplant centers, taking the novel approach of including waitlist outcomes in the analysis. We studied a cohort of 6,482 candidates listed in the Organ Procurement and Transplantation Network for pediatric heart transplantation between 2002 and 2014; 4,665 of the candidates (72%) were transplanted. Candidates were divided into groups according to the average annual transplant volume performed in the listing center during the study period: > 10, 6-10, 3-5, and <3...
March 1, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28248808/continuous-intravenous-milrinone-therapy-in-pediatric-outpatients
#16
Michelle Curley, Jill Liebers, Roy Maynard
Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy...
March 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28236795/therapeutic-monitoring-of-pediatric-transplant-patients-with-conversion-to-generic-tacrolimus
#17
Natalia Riva, Paulo Cáceres Guido, Nieves Licciardone, Oscar Imventarza, Marta Monteverde, Raquel Staciuk, Alberto Charroqui, Paula Schaiquevich
OBJECTIVE: Therapeutic monitoring during interchange of tacrolimus commercial formulations is essential to ensure similar exposure in transplant patients. However, there are limited data in the pediatric transplant population. This study aims to evaluate exposure, safety and efficacy in maintenance pediatric transplant patients under generic tacrolimus substitution. METHOD: Pediatric patients who underwent interchange of tacrolimus formulations were detected by the Service of Pharmacy and included in this study...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28214296/abnormally-high-and-heterogeneous-bone-matrix-mineralization-after-childhood-solid-organ-transplantation-a-complex-pathology-of-low-bone-turnover-and-local-defects-in-mineralization
#18
Nadja Fratzl-Zelman, Helena Valta, Renata C Pereira, Barbara M Misof, Paul Roschger, Hannu Jalanko, Kathrine Wesseling-Perry, Klaus Klaushofer, Outi Mäkitie
Chronic renal, liver and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. We measured BMDD in the entire cross-sectional area of transiliac bone biopsies obtained from kidney (n = 9), liver (n = 9) and heart (n = 5) transplant recipients (aged 7...
February 18, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28213954/human-herpes-virus-6-infection-in-pediatric-organ-transplant-patients
#19
Elisa Ylinen, Silja Lehtinen, Timo Jahnukainen, Teemu Karlsson, Raisa Loginov, Laura Mannonen, Irmeli Lautenschlager, Hannu Jalanko
Transplant patients need lifelong immunosuppressive medication, but this reduces their defense mechanisms, making them prone to viral infections and reactivations. We aimed to clarify the prevalence and clinical manifestations of the human herpes virus 6 (HHV-6) infection in children after pediatric solid organ transplants. Clinical findings and viral loads were compared between primary HHV-6 infections and reactivations. The study comprised 47 kidney, 25 liver, and 12 heart transplant patients who underwent surgery from 2009 to 2014...
February 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28198130/psychosocial-predictors-of-medication-adherence-in-pediatric-heart-and-lung-organ-transplantation
#20
Michael O Killian
Few studies have identified the psychosocial characteristics of those children and their families associated with future non-adherence to immunosuppressive medications following a heart or lung transplant. UNOS data and medical records information were used to test the association between patient and family psychosocial characteristics and medication adherence. Medication adherence outcomes were obtained using the physician assessments in the UNOS data and measured through patient-level standard deviation scores of immunosuppressive medication blood levels...
February 15, 2017: Pediatric Transplantation
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