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Pre-transplant Recipient Evaluation in childrens

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https://www.readbyqxmd.com/read/29496562/impaired-bone-mineral-density-in-pediatric-patients-with-chronic-graft-versus-host-disease
#1
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplant (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk of endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We describe 33 patients with cGVHD that were referred to the NIH for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-Versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessments via dual-energy X-ray absorptiometry (DEXA)...
February 26, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29446208/study-rationale-design-and-pre-transplant-alloantibody-status-a-first-report-of-clinical-trials-in-organ-transplantation-in-children-04-ctotc-04-in-pediatric-heart-transplantation
#2
Warren A Zuckerman, Adriana Zeevi, Kristen L Mason, Brian Feingold, Carol Bentlejewski, Linda J Addonizio, Elizabeth D Blume, Charles E Canter, Anne I Dipchand, Daphne T Hsu, Robert E Shaddy, William T Mahle, Anthony J Demetris, David M Briscoe, Thalachallour Mohanakumar, Joseph M Ahearn, David N Iklé, Brian D Armstrong, Yvonne Morrison, Helena Diop, Jonah Odim, Steven A Webber
Anti-HLA donor-specific antibodies are associated with worse outcomes following organ transplantation. Among sensitized pediatric heart candidates, requirement for negative donor-specific cytotoxicity crossmatch increases wait times and mortality. However, transplantation with positive crossmatch may increase post-transplant morbidity and mortality. We address this clinical challenge in a prospective, multi-center, observational cohort study of children listed for heart transplantation (CTOTC-04). Outcomes were compared among sensitized recipients who underwent transplant with positive crossmatch, non-sensitized recipients, and sensitized recipients without positive crossmatch...
February 15, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29340730/age-dependent-association-between-pre-transplant-blood-transfusion-and-outcomes-of-pediatric-heart-transplantation
#3
C McKee, D Tumin, B R Alevriadou, K K Nicol, A R Yates, D Hayes, J D Tobias
Avoidance of red blood cell (RBC) transfusions in patients awaiting heart transplantation (HTx) has been suggested to minimize the risk of allosensitization. Although recent studies have suggested that an immature immune system in younger HTx recipients may reduce risks associated with RBC transfusion, the role of age in moderating the influence of transfusion on HTx outcomes remains unclear. We used available data from a national transplant registry to explore whether the association between pre-transplant transfusions and outcomes of pediatric HTx varies by patient age...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/28871606/risk-and-outcomes-of-pulmonary-fungal-infection-after-pediatric-lung-transplantation
#4
Evan Ammerman, Stuart C Sweet, Matthew Fenchel, Gregory A Storch, Carol Conrad, Don Hayes, Albert Faro, Samuel Goldfarb, Ernestina Melicoff, Marc Schecter, Gary Visner, Nikki M Williams, Lara Danziger-Isakov
BACKGROUND: Prospective studies to determine associated risk factors and related outcomes for pulmonary fungal infection (PFI) after pediatric lung transplant (PLT) are lacking. METHODS: NIH-sponsored Clinical Trials in Organ Transplantation in Children enrolled PLT candidates, collecting data prospectively for 2 years post-transplant. Demographics, signs/symptoms, radiology, pathology and microbiology were collected. Analyses evaluated for PFI-related risks and outcomes...
November 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28869325/epstein-barr-virus-infection-in-children-with-renal-transplantation-a-single-center-experience
#5
Jihye You, Mijin Kim, Jina Lee, Duck Jong Han, Young Seo Park, Joo Hoon Lee
AIM: This study aimed to investigate the incidence, timing, manifestations, managements, and outcomes of Epstein-Barr virus (EBV) infection in pediatric renal transplant recipients in Korea. METHODS: We retrospectively evaluated 70 patients aged <18 years who had undergone renal transplantation between January 1990 and November 2014 at a single center in Korea. EBV infection was diagnosed via serological test or real-time quantitative polymerase chain reaction (PCR)...
September 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28715116/delayed-transplantation-may-affect-intellectual-ability-in-children
#6
Jiwon M Lee, Yeon Kyung Jung, Jeong-Hoon Bae, Sun Ah Yoon, Ju Hee Kim, YoungRok Choi, Hyeyoung Kim, Kwang-Woong Lee, Hye Young Ahn, Jae Won Kim, Min-Sup Shin, Kyung-Suk Suh, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang, Nam-Joon Yi
BACKGROUND: Decline in neurocognitive function is a reported complication in children with chronic illness. Concerns have been increasing that exposure to a major surgery or trauma may negatively affect cognitive performance in children. This study evaluated cognitive function in 43 Korean children who received organ transplantation (Tx), and sought to identify associated clinical factors. METHODS: Pediatric recipients of kidney (KT) or liver Tx (LT) from 1999 to 2011 were recruited for cognitive tests...
October 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28627425/a-multicenter-retrospective-analysis-stressing-the-importance-of-long-term-follow-up-after-hematopoietic-cell-transplantation-for-%C3%AE-thalassemia
#7
Sonali Chaudhury, M Ayas, Colleen Rosen, Madeline Ma, M Viqaruddin, Suhag Parikh, Sandhya Kharbanda, K Y Chiang, Ann Haight, Monica Bhatia, Greg Guilcher, Alexis Thompson, Shalini Shenoy
Allogeneic hematopoietic cell transplantation (HCT) is curative in patients with β-thalassemia major. However, most reports on HCT outcomes lack long-term follow-up data with the exception of single-center reports. An international multicenter retrospective data collection and analysis was conducted in 176 β-thalassemia patients who were 1 year or beyond after first HCT to evaluate follow-up methods and outcomes at 7 centers. Median age at HCT was 5.5 years (range, .6 to 18.5), and median follow-up was 7 years (range, 1 to 20)...
June 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28321975/the-medication-level-variability-index-mlvi-predicts-poor-liver-transplant-outcomes-a-prospective-multi-site-study
#8
E Shemesh, J C Bucuvalas, R Anand, G V Mazariegos, E M Alonso, R S Venick, M Reyes-Mugica, R A Annunziato, B L Shneider
Nonadherence to immunosuppressant medications is a leading cause of poor long-term outcomes in transplant recipients. The Medication Level Variability Index (MLVI) provides a vehicle for transplant outcome risk-stratification through continuous assessment of adherence. The MALT (Medication Adherence in children who had a Liver Transplant) prospective multi-site study evaluated whether MLVI predicts late acute rejection (LAR). Four hundred pediatric (1-17-year-old) liver transplant recipients were enrolled and followed for 2 years...
October 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28156553/are-families-the-barrier-evaluating-attitudes-toward-early-integration-of-palliative-care-in-pediatric-hematopoietic-stem-cell-transplant
#9
Justin N Baker
112 Background: The benefits of early integration of palliative care (PC) in oncology have been well established yet, there remain significant barriers to PC integration, especially in the setting of pediatric hematopoietic stem cell transplant (HSCT). HSCT patients are prone to a great degree of treatment related toxicity and are at high risk for morbidity and mortality and, while ideally suited to benefit, inherent factors in this cure oriented field preclude the integration of PC services. Most notably, family receptivity to PC is often perceived as a barrier in HSCT yet there is no data on family attitudes toward PC in this setting...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27989013/relationship-among-viremia-viral-infection-alloimmunity-and-nutritional-parameters-in-the-first-year-after-pediatric-kidney-transplantation
#10
R Ettenger, H Chin, K Kesler, N Bridges, P Grimm, E F Reed, M Sarwal, R Sibley, E Tsai, B Warshaw, A D Kirk
The Immune Development in Pediatric Transplantation (IMPACT) study was conducted to evaluate relationships among alloimmunity, protective immunity, immune development, physical parameters, and clinical outcome in children undergoing kidney transplantation. We prospectively evaluated biopsy-proven acute rejection (BPAR), de novo donor-specific antibody (dnDSA) formation, viremia, viral infection, T cell immunophenotyping, and body mass index (BMI)/weight Z scores in the first year posttransplantation in 106 pediatric kidney transplant recipients...
June 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27795988/sex-related-differences-in-the-risk-of-antibody-mediated-rejection-and-subsequent-allograft-vasculopathy-post-heart-transplantation-a-single-center-experience
#11
Avishay Grupper, Emilija M Nestorovic, Richard C Daly, Natasa M Milic, Lyle D Joyce, John M Stulak, David L Joyce, Brooks S Edwards, Naveen L Pereira, Sudhir S Kushwaha
BACKGROUND: Pregnancies may result in antibodies against HLA, a risk factor for antibody-mediated rejection (AMR) and subsequent cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). The aim of this study was to evaluate sex differences in the incidence of AMR events and subsequent risk of CAV among HTx recipients. METHODS: The study comprised 160 patients (51 [32%] women) who underwent HTx in 2008 to 2014. The cumulative effect of AMR events was calculated by AMR score (sum of myocardial biopsy grading divided by number of biopsies taken during 3 years post-HTx)...
October 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27778091/delayed-graft-function-and-its-management-in-children
#12
Ryszard Grenda
Delayed graft function (DGF) is commonly defined as the requirement for dialysis within the first 7 days following renal transplantation. The major underlying mechanism is related to ischaemia/reperfusion injury, which includes microvascular inflammation and cell death and apoptosis, and to the regeneration processes. Several clinical factors related to donor, recipient and organ procurement/transplantation procedures may increase the risk of DGF, including donor cardiovascular instability, older donor age, donor creatinine concentration, long cold ischaemia time and marked body mass index of both the donor and recipient...
July 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27770258/kidney-transplantation-fails-to-provide-adequate-growth-in-children-with-chronic-kidney-disease-born-small-for-gestational-age
#13
Doris Franke, Rena Steffens, Lena Thomas, Leo Pavičić, Thurid Ahlenstiel, Lars Pape, Jutta Gellermann, Dominik Müller, Uwe Querfeld, Dieter Haffner, Miroslav Živičnjak
BACKGROUND: Children with chronic kidney disease are frequently born small for gestational age (SGA) and prone to disproportionately short stature. It is unclear how SGA affects growth after kidney transplantation (KTx). METHODS: Linear growth (height, sitting height, and leg length) was prospectively investigated in a cohort of 322 pediatric KTx recipients, with a mean follow-up of 4.9 years. Sitting height index (ratio of sitting height to total body height) was used to assess body proportions...
March 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27589263/evaluation-of-a-family-camp-intervention-for-children-with-a-heart-transplant-and-their-families
#14
David B Nicholas, Bernadette Dodd, Simon Urschel, Amber Young, Lori J West
Given the arduous course of heart transplantation and follow-up care, recipients and their families face complex challenges and stressors warranting supportive interventions. This study explored the impact of a family camp as an intervention of education and social support for pediatric transplant recipients and their families. A total of 49 individuals participated in this evaluation, including eight children and nine youth with heart transplants, five siblings, 19 parents, and 13 health care providers. Participants ranked and described the 3-day family camp experience...
October 2016: Social Work in Health Care
https://www.readbyqxmd.com/read/27485733/-safety-and-utility-of-percutaneous-liver-biopsy-in-hematopoietic-stem-cell-transplant-pediatric-recipients-a-retrospective-study
#15
Natalia Maximova, Massimo Gregori, Francesca Barbieri, Antonio Pizzol, Aurelio Sonzogni
BACKGROUND: Liver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children. METHODS: The study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17...
August 2, 2016: BMC Cancer
https://www.readbyqxmd.com/read/26964698/outcomes-of-allogeneic-hematopoietic-cell-transplantation-in-children-and-young-adults-with-chronic-myeloid-leukemia-a-cibmtr-cohort-analysis
#16
Sonali Chaudhury, Rodney Sparapani, Zhen-Huan Hu, Taiga Nishihori, Hisham Abdel-Azim, Adriana Malone, Richard Olsson, Mehdi Hamadani, Andrew Daly, Ulrike Bacher, Baldeep M Wirk, Rammurti T Kamble, Robert P Gale, William A Wood, Gregory Hale, Peter H Wiernik, Shahrukh K Hashmi, David Marks, Celalettin Ustun, Reinhold Munker, Bipin N Savani, Edwin Alyea, Uday Popat, Ronald Sobecks, Matt Kalaycio, Richard Maziarz, Nobuko Hijiya, Wael Saber
Chronic myeloid leukemia (CML) in children and young adults is uncommon. Young patients have long life expectancies and low morbidity with hematopoietic cell transplantation (HCT). Prolonged tyrosine kinase inhibitor (TKI) use may cause significant morbidity. In addition, indication for HCT in patients in the first chronic phase is not established. We hence retrospectively evaluated outcomes in 449 CML patients with early disease receiving myeloablative HCT reported to the CIBMTR. We analyzed various factors affecting outcome, specifically the effect of age and pre-HCT TKI in pediatric patients (age < 18 years, n = 177) and young adults (age 18 to 29 years, n = 272) with the goal of identifying prognostic factors...
June 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/26910645/tacrolimus-predose-concentration-is-associated-with-hypertension-in-pediatric-liver-transplant-recipients
#17
Agnieszka Prytula, Kristof Vandekerckhove, Ann Raes, Daniel De Wolf, Jo Dehoorne, Johan Vande Walle, Ruth De Bruyne
BACKGROUND: The aim of the study was to analyze the incidence of hypertension in pediatric liver transplantation (LT) recipients using ambulatory blood pressure measurements (ABPM) and to identify factors associated with hypertension. We also investigated whether hypertension or tacrolimus predose concentration (TAC C0) was associated with increased left ventricular (LV) wall thickness. PATIENTS AND METHODS: On a retrospective longitudinal base, we included 39 pediatric LT recipients...
December 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/26636526/treatment-of-childhood-leukemia-with-haploidentical-hematopoietic-stem-cell-transplantation-using-parent-as-donor-a-single-center-study-of-111-case
#18
Y Sun, J Xiao, Z H Li, S F Fan, Y Shen
OBJECTIVE: In the present study, the outcomes of childhood leukemia treated with haplo-HSCT using parent as donor were evaluated and the risk factors for survival were identified. PATIENTS AND METHODS: 111 consecutive cases from March 2002 to March 2012 in our center were analyzed. The median age of patients was 10 (3-14) years old. All patients received unmanipulated combined marrow and peripheral blood stem cells for transplant after conditioning with busulfan and cyclophosphamide (Cy)/Cy and total body irradiation (TBI) plus antithymocyte globulin (ATG)...
November 2015: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/26482350/the-role-of-medical-air-rescue-services-in-medical-transport-of-organ-recipients-in-poland-organizational-solutions-supporting-transplantation-medicine
#19
Robert Gałązkowski, Agata Pawlak, Daniel Rabczenko, Grzegorz Michalak, Michał M Farkowski, Roman Danielewicz, Maciej Sterliński
BACKGROUND: The aim of this study was to analyze the use of fixed-wing air ambulance (FWAA) services in Poland during the period 2012-2013, with particular emphasis on air transport of organ recipients to transplantation centers. MATERIAL AND METHODS: This was a retrospective, cross-sectional analysis of data derived from standard FWAA medical documentation. RESULTS: In the years 2012-2013 there were 500 emergency (52.7%) and 447 elective (47...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/26069765/chickenpox-infection-after-renal-transplantation
#20
Anupma Kaul, Raj K Sharma, Dharmendra Bhadhuria, Amit Gupta, Narayan Prasad
BACKGROUND: Chicken pox, although a common infection among children, is rare in immunocompromised patients, particularly renal transplant recipients, and carries a very high incidence of morbidity and mortality There is little data on chickenpox in adult renal transplant recipients, although reports have suggested that it may follow a virulent course requiring frequent hospitalization, and in severe cases can cause death. AIMS: To evaluate the incidence, severity and complications of a varicella/chickenpox infection in renal transplant recipients over 10 years follow-up...
June 2012: Clinical Kidney Journal
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