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pediatric kidney transplantation

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https://www.readbyqxmd.com/read/28229376/the-pharmacogenetics-of-tacrolimus-in-corticosteroid-sparse-pediatric-and-adult-kidney-transplant-recipients
#1
Mads Juul Madsen, Troels K Bergmann, Kim Brøsen, Helle Charlotte Thiesson
INTRODUCTION: Tacrolimus is a calcineurin inhibitor used as an immunosuppressant drug in solid organ transplantation, and is mainly metabolized by cytochrome P450 (CYP) 3A4 and CYP3A5. Studies have shown an association between the CYP3A5 genotype and tacrolimus dose-adjusted trough concentrations. Variants in the genes PPARA, POR and CYP3A4 have recently been shown to influence tacrolimus metabolism. Furthermore, pharmacokinetic interaction between corticosteroid treatment and tacrolimus has been shown...
February 22, 2017: Drugs in R&D
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
#2
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
#3
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/28213687/ofatumumab-for-the-treatment-of-childhood-nephrotic-syndrome
#4
Chia-Shi Wang, Rochelle Schmidt Liverman, Rouba Garro, Roshan Punnoose George, Anastacia Glumova, Alana Karp, Stephanie Jernigan, Barry Warshaw
BACKGROUND: Ofatumumab is a humanized anti-CD20 monoclonal antibody that has recently garnered interest as a potential therapeutic agent for nephrotic syndrome. We report our center's experience in administering ofatumumab to five pediatric patients with idiopathic nephrotic syndrome. METHODS: Between March 2015 and November 2016, five patients were treated with ofatumumab. One patient had post-transplant recurrent focal segmental glomerulosclerosis (FSGS) which had been resistant to plasmapheresis and numerous immunosuppressive agents...
February 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28197039/surgical-illustration-of-en-bloc-dual-kidney-transplant-from-a-16-month-old-brain-dead-donor-to-an-adult-recipient
#5
Vikas Jain, Saurabh Jain, Paras Singhal, Suman Lata Nayak, Rajendra P Mathur
Transplantable organs from pediatric donors have been contributing significantly to donor pool worldwide. Pediatric donors are excellent resources that should be procured whenever available, and with the recent increase in deceased donations in India, more pediatric donors will be available for organ harvesting. We share a rare instance of multi-organ harvesting from a 16-month old brain dead donor and implanting both kidneys en-bloc in an adult male, while liver went to a 4-year old child. The report provides the surgical illustration of salient steps of transplanting both kidneys from pediatric donor into an adult, in an en-bloc manner...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28196048/the-phs-increased-risk-label-is-associated-with-nonutilization-of-hundreds-of-organs-per-year
#6
Michael L Volk, Amber R Wilk, Cameron Wolfe, Daniel R Kaul
BACKGROUND: The Public Health Service "Increased Risk" (PHS IR) designation identifies donors at increased risk of transmitting hepatitis B, C, and human immunodeficiency virus. Although the risk remains very low in the era of nucleic acid testing, we hypothesized that this label may result in decreased organ utilization. METHODS: Organ Procurement and Transplantation Network (OPTN) data were used to compare utilization rates between PHS-IR and non-PHS-IR donors, as well as to compare export rates and variation in utilization...
February 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28191751/decreasing-living-donor-rates-in-pediatric-kidney-transplantation-a-time-for-action
#7
EDITORIAL
Jodi M Smith, Eileen D Brewer
No abstract text is available yet for this article.
March 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28181361/a-systematic-review-of-parent-and-family-functioning-in-pediatric-solid-organ-transplant-populations
#8
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/28164508/urinary-neutrophil-gelatinase-associated-lipocalin-does-not-distinguish-acute-rejection-from-other-causes-of-acute-kidney-injury-in-pediatric-renal-transplant-recipients
#9
Tomas Seeman, Karel Vondrak, Jiri Dusek, Nadezda Simankova, Jakub Zieg, Jaromir Hacek, Maria Chadimova, Bruno Sopko, Magdalena Fortova
BACKGROUND: The aim of this prospective single center study was to investigate the ability of urinary neutrophil gelatinase-associated lipocalin (NGAL) to distinguish acute rejection from other causes of acute kidney injury (AKI) in children after renal transplantation. METHODS: Fifteen children fulfilled the inclusion criteria (acute kidney injury (AKI) with allograft biopsy, at least 21 days after renal transplantation, no sepsis) during 2013 - 2014 in our pediatric transplantation center...
January 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28145649/clinical-characteristics-of-transplant-associated-encephalopathy-in-children
#10
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/28145624/severe-intellectual-disability-is-not-a-contraindication-to-kidney-transplantation-in-children
#11
Ashton Chen, Alan Farney, Gregory B Russell, Linda Nicolotti, Robert Stratta, Jeffrey Rogers, Jen-Jar Lin
Renal transplantation in children with ID is controversial. Acceptability of these children as candidates varies between programs. Limited outcome data in pediatric renal TXP recipients with cognitive impairment diminish their access to TXP. A retrospective chart review was performed of all children who underwent renal transplantation between January 1, 2002 and June 30, 2012 (N=72). Patients were divided into two groups, those with ID prior to transplantation (n=10) and those without (non-ID; n=62). Graft survival and BPAR episodes were compared between the two groups using Kaplan-Meier estimates...
February 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28133940/outcomes-of-pediatric-living-donor-kidney-transplantation-a%C3%A2-single-center-experience
#12
Sonia Pérez-Bertólez, Rafael Barrero, Julia Fijo, Verónica Alonso, Devicka Ojha, Miguel Ángel Fernández-Hurtado, Jerónimo Martínez, Eduardo León, Francisco García-Merino
Renal transplantation is the treatment of choice for children with ESRD offering advantages of improved survival, growth potential, cognitive development, and quality of life. The aim of our study was to compare the outcomes of LDKT vs DDKT performed in children at a single center. Retrospective chart review of pediatric patients who underwent kidney transplantation from 2005 to 2014 was performed. Ninety-one renal transplants were accomplished, and 31 cases (38.27%) were LDKT, and in 96.7% of the cases, the graft was obtained through laparoscopy...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28133935/post-transplant-immune-complex-nephritis-in-a-patient-with-systemic-lupus-erythematosus-associated-with-anca-vasculitis
#13
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28132852/treatment-of-posttransplant-lymphocele-in-children
#14
Romy Gander, Marino Asensio, Gloria Fatou Royo, Jose Andrés Molino, Ramón Vilalta, Ana Coma, Mercedes Perez, Gema Ariceta
OBJECTIVE: To review our single-center experience in managing posttransplant lymphoceles in pediatric kidney recipients. Lymphoceles are well-known complications after pediatric kidney transplantation (KT). However, there is no standard treatment for lymphoceles, and the literature lacks consensus on which is the most appropriate approach. MATERIALS AND METHODS: We reviewed our retrospective institutional database for recipients of pediatric KT performed between January 2000 and December 2015 who developed lymphoceles...
January 26, 2017: Urology
https://www.readbyqxmd.com/read/28128720/surgical-complications-after-pediatric-renal-transplant
#15
Hakan Sözen, Kibriya Fidan, Onur Özen, Oğuz Söylemezoğlu, Aydın Dalgıç
OBJECTIVES: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. MATERIALS AND METHODS: We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid)...
January 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28121909/urinary-metabolomics-for-noninvasive-detection-of-antibody-mediated-rejection-in-children-after-kidney-transplantation
#16
Tom D Blydt-Hansen, Atul Sharma, Ian W Gibson, David S Wishart, Rupasri Mandal, Julie Ho, Peter Nickerson, David Rush
BACKGROUND: Biomarkers are needed that identify patients with antibody-mediated rejection (ABMR). The goal of this study was to evaluate the utility of urinary metabolomics for early noninvasive detection of ABMR in pediatric kidney transplant recipients. METHODS: Urine samples (n=396) from a prospective, observational cohort of 59 renal transplant patients with surveillance or indication biopsies were assayed for 133 unique metabolites by quantitative mass spectrometry...
January 25, 2017: Transplantation
https://www.readbyqxmd.com/read/28104153/pharmacokinetic-profile-of-twice-and-once-daily-tacrolimus-in-pediatric-kidney-transplant-recipients
#17
Y Takahashi, S Shishido, Y Hyodo, T Yonekura, H Nihei, Y Itabashi, M Muramatsu, Y Hamasaki, T Kawamura, A Aikawa
BACKGROUND: The aim of this study was to assess the differences in pharmacokinetic (PK) profiles after the 1:1 ratio-based conversion from a twice-daily to a once-daily tacrolimus formulation (TD-TAC and OD-TAC, respectively) in pediatric recipients of kidney transplants. METHODS: TD-TAC was initially administered to 29 pediatric patients who underwent kidney transplantations between April 2010 and September 2015 and were then subsequently switched to OD-TAC. The switch dose ratio was 1:1, and the 24-hour complete PK parameter assessment was performed before and after the regimen was changed from TD-TAC to OD-TAC...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#18
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
https://www.readbyqxmd.com/read/28094348/weight-of-abcb1-and-por-genes-on-oral-tacrolimus-exposure-in-cyp3a5-nonexpressor-pediatric-patients-with-stable-kidney-transplant
#19
G N Almeida-Paulo, I Dapía García, R Lubomirov, A M Borobia, N L Alonso-Sánchez, L Espinosa, A J Carcas-Sansuán
Tacrolimus (TAC) is highly effective for the prevention of acute organ rejection. However, its clinical use may be challenging due to its large interindividual pharmacokinetic variability, which can be partially explained by genetic variations in TAC-metabolizing enzymes and transporters. The aim of this study was to evaluate the influence of genetic and clinical factors on TAC pharmacokinetic variability in 21 stable pediatric renal transplant patients. This study was nested in a previous Prograf to Advagraf conversion clinical trial...
January 17, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28092129/bortezomib-in-the-treatment-of-antibody-mediated-rejection-in-pediatric-kidney-transplant-recipients-a-multicenter-midwest-pediatric-nephrology-consortium-study
#20
Sarah Kizilbash, Donna Claes, Isa Ashoor, Ashton Chen, Sara Jandeska, Raed Bou Matar, Jason Misurac, Joseph Sherbotie, Katherine Twombley, Priya Verghese
Antibody-mediated rejection leads to allograft loss after kidney transplantation. Bortezomib has been used in adults for the reversal of antibody-mediated rejection; however, pediatric data are limited. This retrospective study was conducted in collaboration with the Midwest Pediatric Nephrology Consortium. Pediatric kidney transplant recipients who received bortezomib for biopsy-proven antibody-mediated rejection between 2008 and 2015 were included. The objective was to characterize the use of bortezomib in pediatric kidney transplant recipients...
January 16, 2017: Pediatric Transplantation
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