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Pediatric heart transplantation

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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28193717/differences-in-presentation-and-outcomes-between-children-with-familial-dilated-cardiomyopathy-and-children-with-idiopathic-dilated-cardiomyopathy-a-report-from-the-pediatric-cardiomyopathy-registry-study-group
#4
Paolo Rusconi, James D Wilkinson, Lynn A Sleeper, Minmin Lu, Gerald F Cox, Jeffrey A Towbin, Steven D Colan, Steven A Webber, Charles E Canter, Stephanie M Ware, Daphne T Hsu, Wendy K Chung, John L Jefferies, Christina Cordero, Steven E Lipshultz
BACKGROUND: Research comparing the survival of children with familial dilated cardiomyopathy (FDCM) to that of children with idiopathic dilated cardiomyopathy (IDCM) has produced conflicting results. METHODS AND RESULTS: We analyzed data from children with FDCM or IDCM using the National Heart, Lung, and Blood Institute-funded Pediatric Cardiomyopathy Registry. Compared to children with IDCM (n=647), children with FDCM (n=223) were older (mean 6.2 versus 4.5 years, P<0...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28191755/the-impact-of-cognitive-delay-on-pediatric-heart-transplant-outcomes
#5
Christopher Prendergast, Meghann McKane, Debra A Dodd, Justin Godown
The presence of CD may be viewed as a relative contraindication to transplantation; however, its impact on pediatric HTx outcomes is poorly characterized. The aim of this study was to assess the impact of CD on pediatric HTx outcomes using academic progress as a surrogate measure of cognitive performance. The OPTN database was queried for all pediatric HTx recipients (2004-2014) with reported academic progress. Multivariable analysis assessed the impact of DGL and the need for SE on post-HTx graft survival...
March 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28191005/significance-of-anti-hla-antibodies-on-adult-and-pediatric-heart-allograft-outcomes
#6
REVIEW
Massimo Mangiola, Marilyn Marrari, Brian Feingold, Adriana Zeevi
As methods for human leukocyte antigens (HLA) antibody detection have evolved and newer solid phase assays are much more sensitive, the last 15 years has seen a renewed focus on the importance of HLA antibodies in solid organ transplant rejection. However, there is still much controversy regarding the clinical significance of antibody level as depicted by the mean fluorescence intensity of a patient's neat serum. Emerging techniques, including those that identify antibody level and function, show promise for the detection of individuals at risk of allograft rejection, determination of the effectiveness of desensitization prior to transplant, and for monitoring treatment of rejection...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28186850/the-use-of-dexmedetomidine-in-pediatric-palliative-care-a-preliminary-study
#7
Jamie Burns, Kevin Jackson, Kathy A Sheehy, Julia C Finkel, Zenaide M Quezado
OBJECTIVE: To evaluate the effect of dexmedetomidine infusions in patients with advanced malignancies, advanced heart disease, or after stem cell transplantation (SCT), who during end-of-life care had pain and/or agitation unresponsive to conventional therapies. BACKGROUND: Pediatric patients with intractable advanced malignancies, end-stage congenital heart diseases, or after SCT can suffer a great deal during end of life. Pain, drowsiness, fatigue, irritability, and worrying are experienced frequently, considered distressing, and are strongly associated with reductions in health-related quality-of-life scores...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28184975/alkaline-phosphatase-a-biomarker-of-cardiac-function-in-pediatric-patients
#8
Elizabeth S Makil, Xinyu Tang, Elizabeth A Frazier, R Thomas Collins
Myocardial dysfunction and heart failure are common in pediatric patients with congenital and acquired heart disease. Alkaline phosphatase (AP) has been suggested as a biomarker for myocardial dysfunction after Fontan operation. We hypothesized that pediatric patients with myocardial dysfunction requiring orthotopic heart transplant (OHT) have diminished AP compared to normal. A retrospective review was performed in all patients who underwent OHT at Arkansas Children's Hospital between January 2007 and October 2012...
February 9, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28181361/a-systematic-review-of-parent-and-family-functioning-in-pediatric-solid-organ-transplant-populations
#9
REVIEW
Melissa K Cousino, Kelly E Rea, Kurt R Schumacher, John C Magee, Emily M Fredericks
The process of pediatric solid organ transplantation (SOT) places new and increased stressors on patients and family members. Measures of family functioning may predict psychological and health outcomes for pediatric patients and their families, and provide opportunity for targeted intervention. This systematic review investigated parent and family functioning and factors associated with poorer functioning in the pediatric SOT population. Thirty-seven studies were identified and reviewed. Studies featured a range of organ populations (eg, heart, liver, kidney, lung, intestine) at various stages in the transplant process...
February 8, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28181355/measures-of-and-changes-in-heart-rate-variability-in-pediatric-heart-transplant-recipients
#10
T Williams, X Tang, G Gilmore, J Gossett, K R Knecht
Heart rate variability is primarily regulated by the autonomic nervous system. Heart transplant recipients undergo surgical denervation of the graft, which results in interruption of autonomic innervation with resultant diminished heart rate variability although some degree of autonomic control may return. This study aimed to characterize heart rate variability in this population. We report a retrospective review of Holter monitor data from transplanted patients between 2005 and 2013. Studies with significant atrial or ventricular arrhythmias were excluded...
February 8, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28174391/-ventricular-assist-device
#11
Minoru Ono
In Japan the 1st paracorporeal ventricular assist device (VAD) was implanted in 1980. Since then, more than 2,000 VADs were used. Small size continuous-flow VAD (CFVAD) was developed in 1990s, which dramatically improved safety and efficacy of long-term support. EVAHEART and DuraHeart, both of which were developed in Japan, were approved for health insurance coverage in 2011, followed by approval of HeartMate II in 2013 and Jarvik 2000 in 2014. Although these approvals were limited for bridge to transplantation, CFVADs gained rapid acceptance for treatment of end-stage heart failure...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28163432/early-primary-graft-failure-after-a-pediatric-heart-transplant-and-successful-rescue-with-plasmapheresis-immunoglobulins-and-alemtuzumab
#12
Shashi Raj, Phillip Ruiz, Paolo Rusconi
Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28162930/a-randomized-study-of-autologous-bone-marrow-derived-stem-cells-in-pediatric-cardiomyopathy
#13
E Sian Pincott, Deborah Ridout, Margaret Brocklesby, Angus McEwan, Vivek Muthurangu, Michael Burch
BACKGROUND: Bone marrow mononuclear cell fraction has been used as therapy for dilated cardiomyopathy in adults. Although case series are reported, there are no randomized controlled studies in children. METHODS: We designed a randomized, crossover, controlled pilot study to determine safety and feasibility of intracoronary stem cell therapy in children. The primary safety end-point was freedom from death and transplantation or any complication that could be considered related to bone marrow injection or anesthesia (e...
January 5, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28161809/alteration-of-cardiac-deformation-in-acute-rejection-in-pediatric-heart-transplant-recipients
#14
Nitin Chanana, Charlotte S Van Dorn, Melanie D Everitt, Hsin Yi Weng, Dylan V Miller, Shaji C Menon
The objective of this study is to assess changes in cardiac deformation during acute cellular- and antibody-mediated rejection in pediatric HT recipients. Pediatric HT recipients aged ≤18 years with at least one episode of biopsy-diagnosed rejection from 2006 to 2013 were included. Left ventricular systolic S (SS) and SR (SSr) data were acquired using 2D speckle tracking on echocardiograms obtained within 12 h of right ventricular endomyocardial biopsy. A mixed effect model was used to compare cardiac deformation during CR (Grade ≥ 1R), AMR (pAMR ≥ 2), and mixed rejection (CR and AMR positive) versus no rejection (Grade 0R and pAMR 0 or 1)...
February 4, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28151005/allograft-heart-valves-current-aspects-and-future-applications
#15
Milan Lisy, Guenay Kalender, Katja Schenke-Layland, Kelvin G M Brockbank, Anna Biermann, Ulrich Alfred Stock
Human heart valve allografts continue to represent almost perfect substitutes for heart valves. They have optimal hemodynamic characteristics and are highly resistant to infections. The first clinical use of allograft heart valves was as homovitals being transplanted after antibiotic incubation without any preservation. Since 1968, relatively standardized frozen cryopreservation (SFC) has been employed, including storage in vapor-phase liquid nitrogen. Disadvantages, particularly in pediatric patients, are limited availability due to organ scarcity, inability to grow, degeneration, immune response, and long-term failure...
February 2, 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28145649/clinical-characteristics-of-transplant-associated-encephalopathy-in-children
#16
Yun Jeong Lee, Mi Sun Yum, Eun Hee Kim, Min Jee Kim, Kyung Mo Kim, Ho Joon Im, Young Hwue Kim, Young Seo Park, Tae Sung Ko
We aimed to analyze characteristics of encephalopathy after both hematopoietic stem cell and solid organ pediatric transplantation. We retrospectively reviewed medical records of 662 pediatric transplant recipients (201 with liver transplantation [LT], 55 with heart transplantation [HT], and 67 with kidney transplantation [KT], 339 with allogeneic hematopoietic stem cell transplantation [HSCT]) who received their graft organs at Asan Medical Center between January 2000 and July 2014. Of the 662 patients, 50 (7...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28127883/striking-a-balance-between-equity-and-exceptionality-in-pediatric-heart-transplantation
#17
EDITORIAL
Steven J Kindel
No abstract text is available yet for this article.
February 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28125462/united-states-trends-in-pediatric-ventricular-assist-implantation-as-bridge-to-transplantation
#18
Chet R Villa, Muhammad S Khan, Farhan Zafar, David Ls Morales, Angela Lorts
Ventricular assist devices (VADs) are increasingly used to support children to heart transplant however, it is unclear if this trend is broadly applicable across the age/size spectrum. Children (<18years) listed for transplant were identified within in the United Network of Organ Sharing (UNOS) database from 1/2006-6/2014. Patients were stratified by era (Early: 2006-2010, Current: 2011-2014), size (<25 kg, 25-50 kg, > 50 kg) and device type. Of 3986 patients, 531 (13%) were supported by a VAD. The proportion of patients supported with a VAD has increased in the current era (16% vs...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28100970/sickle-cell-disease-with-cyanotic-congenital-heart-disease-long-term-outcomes-in-5-children
#19
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
#20
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
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