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Pretransplant in childrens

Shibany P Taormina, Matthew P Galloway, Amrish Jain
A decrease in live donor pediatric kidney transplants has occurred in the United States. This study investigates barriers that may influence access to live donor kidney transplants in children. Retrospective chart review was conducted for 91 children (69% male, mean age 11.9 years) who underwent pretransplant workup from 2005 to 2015 at an urban pediatric hospital. Fifty-four percent were African American, 32% Caucasian, 8% Arabic, 3% Hispanic, and 3% Others. Government-sponsored insurance (Medicaid/Medicare) was utilized by 73%, and 54% had dual caregivers...
November 25, 2016: Pediatric Transplantation
Kenji Kishimoto, Ryoji Kobayashi, Daiki Hori, Hirozumi Sano, Daisuke Suzuki, Kazue Yasuda, Kunihiko Kobayashi
To determine whether pretransplant PSD affects the clinical outcomes in HSCT, a retrospective cohort analysis of 73 pediatric and adolescent patients who underwent HSCT was performed. Pretransplant PSD was defined as the presence of a fluid level or mucosal swelling or total opacity on sinus X-ray or CT examination performed before HSCT. Pretransplant PSD was observed in 21 (29%) patients. The probability of 2-year OS after HSCT was 42% in patients with pretransplant PSD (PSD group), and 64% in those without (non-PSD group) (P=...
October 17, 2016: Pediatric Transplantation
Andrew C Dietz, Christine N Duncan, Blanche P Alter, Dorine Bresters, Morton J Cowan, Luigi Notarangelo, Philip S Rosenberg, Shalini Shenoy, Roderick Skinner, Mark C Walters, John Wagner, K Scott Baker, Michael A Pulsipher
An international consensus conference sponsored by the Pediatric Blood and Marrow Transplant consortium entitled, "Late Effects Screening and Recommendations Following Allogeneic Hematopoietic Cell Transplant for Immune Deficiency and Non-malignant Hematologic Disease was held in Minneapolis, Minnesota on May 10-11, 2016. The purpose of the conference was to address the unmet need for a greater understanding of and the screening for long-term complications in the growing population of survivors of transplantation for non-malignant disorders...
October 10, 2016: Biology of Blood and Marrow Transplantation
Don Hayes, Benjamin T Kopp, Shahid I Sheikh, Richard D Shell, Grace R Paul, Patrick I McConnell, Joseph D Tobias, Dmitry Tumin
Background Pre-lung transplant (LTx) panel reactive antibody (PRA) levels are associated with adverse outcomes in adult LTx recipients, but their impact in pediatric LTx recipients is unknown. Methods The United Network for Organ Sharing registry was queried from 2004 to 2013 to compare survival between pediatric LTx recipients with PRA class I and II levels = 0 versus > 0. Results Overall, 333 pediatric LTx recipients had data on class I or II PRA and were included in the analysis. Univariate analysis demonstrated that PRA > 0 was not associated with survival benefit for class I (hazard ratio [HR] = 0...
September 5, 2016: Thoracic and Cardiovascular Surgeon
Seiichiro Shishido, Takeshi Kawamura, Yuko Hamasaki, Yusuke Takahashi, Yoshihiro Itabashi, Masaki Muramatsu, Hiroyuki Satoh, Atsushi Aikawa
BACKGROUND: Children with a compromised inferior vena cava (IVC) were previously considered unsuitable for kidney transplantation because of the technical difficulties and the increased risk of graft thrombosis secondary to inadequate renal venous outflow. METHODS: We conducted a retrospective study of 11 transplants in 9 patients with end-stage renal disease and thrombosed IVCs who received adult kidney allografts between 2000 and 2015. The mean age at transplantation was 7...
June 2016: Transplantation Direct
Jelena Stojanovic, Anna Adamusiak, Nicos Kessaris, Pankaj Chandak, Zubir Ahmed, Neil J Sebire, Grainne Walsh, Helen E Jones, Stephen D Marks, Nizam Mamode
BACKGROUND: Blood group incompatible transplantation (ABOi) in children is rare as pretransplant conditioning remains challenging and concerns persist about the potential increased risk of rejection. METHODS: We describe the results of 11 ABOi pediatric renal transplant recipients in the 2 largest centers in the United Kingdom, sharing the same tailored desensitization protocol. Patients with pretransplant titers of 1 or more in 8 received rituximab 1 month before transplant; tacrolimus and mycophenolate mofetil were started 1 week before surgery...
July 12, 2016: Transplantation
David S Shulman, Michelle A Lee, Leslie E Lehmann, Steven P Margossian
The management of chronic myelogenous leukemia (CML) in children changed dramatically with the introduction of tyrosine kinase inhibitors (TKIs). Unfortunately, outcomes for patients presenting in an advanced stage-accelerated phase or blast crisis CML-continues to be poor, requiring chemotherapy and allogeneic hematopoietic stem cell transplant (HSCT) to attempt cure. Integration of TKIs in the therapy of advanced CML is still an area of active investigation. There are little published data on TKI use in children with advanced stage CML...
November 2016: Journal of Pediatric Hematology/oncology
Jacob L Bilhartz, Amy K Drayton, Victoria L Shieck
A high-quality critical care team is an essential component of any successful organ transplant program. From pretransplant care to the crucial postoperative period, its importance cannot be discounted. However, because of the focused nature of work in an intensive care unit (ICU), all too often members of the ICU team are not able to see and appreciate the ultimate fruits of their labor. These are factors that can contribute to the high rates of burnout and turnover among ICU teams. This article presents the concept of a summer camp for children who have received a solid-organ transplant...
July 2016: Critical Care Nursing Quarterly
Braiden Eilers, Erin Albers, Yuk Law, D Mike McMullan, Dennis Shaw, Mariska Kemna
Identification of risk factors for PRES after organ transplant can improve early detection and avoid permanent neurological injury. High calcineurin-inhibitor levels and hypertension are recognized risk factors for PRES in adult transplant recipients. Limited data exist regarding PRES after pediatric HTx, with studies limited to case reports. We performed a retrospective review of 128 pediatric HTx recipients to identify risk factors for PRES. Seven of 128 (5.5%) recipients developed PRES at a median of 10 days (5-57) after HTx...
June 2016: Pediatric Transplantation
Vural Kesik, Erman Ataş, Musa Karakükcü, Serap Aksoylar, Fatih Erbey, Nurdan Taçyıldız, Alphan Küpesiz, Haldun Öniz, Ekrem Ünal, Savaş Kansoy, Gülyüz Öztürk, Murat Elli, Zühre Kaya, Ülker Koçak, Emel Ünal, Volkan Hazar, Şebnem Yılmaz Bengoa, Gülsün Karasu, Akif Yeşilipek, Didem Atay, Ayhan Dağdemir, Hale Ören
OBJECTIVE: The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (ASCT) in patients with relapsed/refractory Hodgkin's lymphoma (HL) were evaluated. MATERIAL AND METHODS: The prognostic factors of 61 patients who underwent ASCT between January 1990 and December 2014 were evaluated. In addition, the age-adjusted International Prognostic Index (AAIPI) and the childhood IPI (CIPI) were evaluated for their impact on prognosis...
April 18, 2016: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Bahaaldin Alsoufi, Shriprasad Deshpande, Courtney McCracken, Brian Kogon, Robert Vincent, William T Mahle, Kirk Kanter
OBJECTIVES: Paediatric heart transplantation is performed to salvage children with end-stage heart failure from various underlying pathologies. Despite several developments in all management aspects of transplantation candidates, the effect of those advances on outcomes has not been consistent. We report our institutional experience with focus on examining era effect on early and late survival. METHODS: Between 1988 and 2015, 320 children underwent heart transplantation...
October 2016: European Journal of Cardio-thoracic Surgery
Chethan Ashokkumar, Kyle Soltys, George Mazariegos, Geoffrey Bond, Brandon W Higgs, Mylarappa Ningappa, Qing Sun, Amanda Brown, Jaimie White, Samantha Levy, Tamara Fazzolare, Lisa Remaley, Katie Dirling, Patricia Harris, Tara Hartle, Pamela Kachmar, Megan Nicely, Lindsay OʼToole, Brittany Boehm, Nicole Jativa, Paula Stanley, Ronald Jaffe, Sarangarajan Ranganathan, Adriana Zeevi, Rakesh Sindhi
BACKGROUND: Allospecific CD154+T-cytotoxic memory cells (CD154+TcM) predict acute cellular rejection after liver transplantation (LTx) or intestine transplantation (ITx) in small cohorts of children and can enhance immunosuppression management, but await validation and clinical implementation. METHODS: To establish safety and probable benefit, CD154+TcM were measured in cryopreserved samples from 214 children younger than 21 years (National Clinical Trial 1163578)...
March 4, 2016: Transplantation
Sharon Manne, Laura Mee, Abraham Bartell, Stephen Sands, Deborah A Kashy
OBJECTIVE: Providing care to one's child during and after a hematopoietic stem cell transplant (HSCT) is a universally stressful experience, but few psychological interventions have been developed to reduce caregiver distress. The goal of this study was to test the efficacy of a brief cognitive-behavioral intervention delivered to primary caregivers. METHOD: Two hundred eighteen caregivers were assigned either best-practice psychosocial care (BPC) or a parent social-cognitive intervention program (P-SCIP)...
May 2016: Journal of Consulting and Clinical Psychology
Caner Alparslan, Onder Yavascan, Murat Sait Doğan, Serdar Saritas, Fatma Mutlubas Ozsan, Belde Kasap Demir, Ali Rahmi Bakiler, Nejat Aksu
OBJECTIVES: In this study, our aim was to evaluate the systolic cardiac parameters and related risk factors in children within 6 months after kidney transplant. MATERIALS AND METHODS: We retrospectively evaluated 24 children who received kidney transplants. Clinical and laboratory parameters before and after transplant were recorded. Results were evaluated statistically, with a P value less than .05 considered significant. RESULTS: Before transplant, systolic cardiac functions were within normal limits...
February 11, 2016: Experimental and Clinical Transplantation
Z Demir, P Frange, F Lacaille
Vaccination is an effective strategy to decrease infections in transplant recipients. Children after intestinal transplantation carry a high risk of infection due to increased immunosuppression. In a series of 22 children after intestinal transplantation, we studied the vaccination schedules and the antibodies against vaccine-preventable diseases before transplantation, and at one and five yr after transplantation. We reviewed whether the vaccination schedules were complete, and we analysed the factors that may influence serological immunity and the incidence of disease in patients with deficient immunity...
May 2016: Pediatric Transplantation
Sergio A Acuna, Kimberly A Fernandes, Corinne Daly, Lisa K Hicks, Rinku Sutradhar, S Joseph Kim, Nancy N Baxter
IMPORTANCE: Solid-organ transplant recipients (SOTRs) are at greater risk of developing some cancers than the general population; however, because they are also at increased risk of mortality from noncancer causes, the effect of transplantation on cancer mortality is unclear. OBJECTIVE: To describe cancer mortality in SOTRs and to assess whether SOTRs are at increased risk of cancer mortality compared with the general population. DESIGN, SETTING, AND PARTICIPANTS: Population-based cohort study of patients who underwent solid-organ transplantation in Ontario, Canada, between 1991 and 2010 with 85 557 person-years of follow-up through December 31, 2011...
April 2016: JAMA Oncology
Jhong-Lin Wu, Hsuan-Yin Ma, Chun-Yi Lu, Jong-Min Chen, Ping-Ing Lee, Shiann-Tarng Jou, Yung-Lin Yang, Hsiu-Hao Chang, Meng-Yao Lu, Luan-Ying Chang, Li-Min Huang
BACKGROUND: Cytomegalovirus (CMV) is a major pathogen causing significant mortality and morbidity in immunocompromised hosts. It is important to find risk factors associated with CMV viremia and its outcome. METHODS: We investigated the incidence, time of onset, risk factors for CMV viremia, and characteristics of CMV diseases in 57 pediatric patients receiving hematopoietic stem cell transplantation (HSCT). Between August 2011 and March 2014, cases of pediatric HSCT patients at the National Taiwan University Children's Hospital were reviewed...
August 14, 2015: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Ashley E Walther, Abigail C Coots, Jens W Goebel, Maria H Alonso, Frederick C Ryckman, Greg M Tiao, Jaimie D Nathan
Kidney transplantation is the optimal treatment of ESRD in children. Some studies have reported inferior outcomes in recipients of LDN allografts who are ≤ 5 yr of age. We performed a retrospective review of pediatric recipient outcomes of 110 LDN allografts at our institution and examined predictors of adverse outcomes. Subgroup analysis was performed by dividing recipients into three age categories: 0-5 yr, 6-17 yr, and ≥ 18 yr. There was no significant difference between incidences of DGF or ARE between groups...
December 2015: Pediatric Transplantation
Thomas A Pham, Amy M Gallo, Waldo Concepcion, Carlos O Esquivel, C Andrew Bonham
INTRODUCTION: Hepatoblastoma (HBL) and hepatocellular cancer (HCC) are the most common primary hepatic malignant neoplasms in childhood. Given the rarity of these childhood tumors and their propensity to present at advanced stages, updated long-term data are needed. OBJECTIVE: To determine the efficacy of liver transplant in children with HBL or HCC. DESIGN, PARTICIPANTS, AND SETTING: This single-institution retrospective medical record review and analysis spanned from January 1, 1997, through September 17, 2014, at Stanford University School of Medicine...
December 2015: JAMA Surgery
P Satwani, K W Ahn, J Carreras, H Abdel-Azim, M S Cairo, A Cashen, A I Chen, J B Cohen, L J Costa, C Dandoy, T S Fenske, C O Freytes, S Ganguly, R P Gale, N Ghosh, M S Hertzberg, R J Hayashi, R T Kamble, A S Kanate, A Keating, M A Kharfan-Dabaja, H M Lazarus, D I Marks, T Nishihori, R F Olsson, T D Prestidge, J M Rolon, B N Savani, J M Vose, W A Wood, D J Inwards, V Bachanova, S M Smith, D G Maloney, A Sureda, M Hamadani
Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pretransplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995 and 2010. The probabilities of PFS at 1, 5 and 10 years were 66% (95% confidence interval (CI): 62-70), 52% (95% CI: 48-57) and 47% (95% CI: 42-51), respectively...
November 2015: Bone Marrow Transplantation
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