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Paediatric renal transplant

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https://www.readbyqxmd.com/read/27785625/plasma-cell-rich-infiltrates-in-paediatric-renal-transplant-biopsies-are-associated-with-increased-risk-of-renal-allograft-failure
#1
Stephanie Dufek, Azaz Khalil, Nizam Mamode, Neil J Sebire, Stephen D Marks
BACKGROUND: Increased plasma cell infiltration in renal allograft biopsies is a rare finding associated with poor outcome in adult renal transplant recipients. The clinical impact of increased plasma cell infiltrates in paediatric renal transplant recipients (pRTR) remains unknown. METHODS: We conducted a retrospective case-control study from April 1996 to March 2014 comparing the outcome of pRTR with increased (>10 % of infiltrate) plasma cells in renal transplant biopsies to a control cohort of pRTR without increased plasma cell infiltration but similar grade of rejection according to Banff classification...
October 26, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27747684/confusion-between-two-amphotericin-b-formulations-leading-to-a-paediatric-rehospitalisation
#2
Mapi Fleury, Caroline Fonzo-Christe, Charline Normand, Pascal Bonnabry
A heavily immunosuppressed, 43-kg, 9-year-old patient was recovering from a bone marrow transplant. Primary prophylaxis against invasive fungal infections was liposomal amphotericin B (AmBisome(®), 2.3 mg/kg [100 mg] two times per week). Once home, following a first amphotericin B infusion, he presented with strong diarrhoea and vomiting; this was repeated after the second infusion. The clinical situation worsened rapidly and the patient was rehospitalised. On admission, he presented with acute renal failure...
December 2016: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27742824/renal-transplantation-in-sensitized-children-and-young-adults-a-nationwide-approach
#3
Luca Dello Strologo, Luisa Murer, Isabella Guzzo, Federica Morolli, Annalisa M V Pipicelli, Elisa Benetti, Germana Longo, Sara Testa, Andrea Ricci, Fabrizio Ginevri, Luciana Ghio, Massimo Cardillo, Antonina Piazza, Alessandro Nanni Costa
BACKGROUND: High levels of preformed anti-HLA antibodies dramatically diminish renal transplant outcomes. Most desensitization programmes guarantee good intermediate outcomes but quite disappointing long-term prognosis. The search for a fully compatible kidney increases time on the waiting list. METHODS: In February 2011, a nationwide hyperimmune programme (NHP) was begun in Italy: all available kidneys are primarily proposed to highly sensitized patients with a panel reactive antibody above 80%...
October 14, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27732754/balancing-competing-needs-in-kidney-transplantation-does-an-allocation-system-prioritizing-children-affect-the-renal-transplant-function
#4
Marcus Weitz, Onur Sazpinar, Maria Schmidt, Thomas J Neuhaus, Elisabeth Maurer, Claudia Kuehni, Paloma Parvex, Hassib Chehade, Sibylle Tschumi, Franz Immer, Guido F Laube
Children often merit priority in access to deceased donor kidneys by organ-sharing organizations. We report the impact of the new Swiss Organ Allocation System (SOAS) introduced in 2007, offering all kidney allografts from deceased donors <60 years preferentially to children. The retrospective cohort study included all paediatric transplant patients (<20 years of age) before (n = 19) and after (n = 32) the new SOAS (from 2001 to 2014). Estimated glomerular filtration rate (eGFR), urine protein-to-creatinine ratio (UPC), need for antihypertensive medication, waiting times to kidney transplantation (KTX), number of pre-emptive transplantations and rejections, and the proportion of living donor transplants were considered as outcome parameters...
October 12, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27682140/therapeutic-efficacy-and-safety-of-ace-inhibitors-in-the-hypertensive-paediatric-population-a-review
#5
REVIEW
Evelien Snauwaert, Johan Vande Walle, Pauline De Bruyne
PURPOSE: Since 1997, strong incentives have been introduced worldwide to improve access to safe and effective medicines addressing the therapeutic needs of children. ACE inhibitors, the most prescribed antihypertensive drugs in the paediatric population, are one of the prototype drugs targeted by the legislation initiatives. Our purpose in assembling this review is to evaluate and describe the current evidence for the efficacy and safety profile of ACE inhibitors in the paediatric population...
September 28, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27669677/a-preliminary-study-searching-for-the-right-dose-of-tacrolimus-in-very-young-%C3%A2-4-years-renal-transplant-patients
#6
Lisa C Martial, Ruud H J Verstegen, Elisabeth A M Cornelissen, Rob E Aarnoutse, Michiel F Schreuder, Roger J M Brüggemann
OBJECTIVES: The Radboudumc Amalia Children's hospital in the Netherlands has a programme for renal transplantation in children aged ≤4 years. Children receive chronic corticosteroid sparing immunosuppressive therapy that consists of tacrolimus and mycophenolate mofetil. This work aimed to describe the PK of tacrolimus in children ≤4 years with renal transplants. METHODS: Paediatric renal transplant patients aged ≤4 years were included in this analysis. A PK curve of tacrolimus recorded ≤3 weeks after transplantation has been standard of care in our institution and aided in adjusting the dose in each patient to attain a target AUC0-12h of 210 μg h/l early after transplantation...
September 27, 2016: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27610750/enhancing-the-role-of-paediatric-ultrasound-with-microbubbles-a-review-of-intravenous-applications
#7
Vasileios Rafailidis, Annamaria Deganello, Tom Watson, Paul S Sidhu, Maria E Sellars
Contrast-enhanced Ultrasound (CEUS) represents a complementary technique to grey-scale and colour Doppler ultrasonography (US) which allows for real-time visualization and characterization of tissue perfusion. Its inherent advantages in the child makes US an ideal imaging modality; repeatability and good tolerance along with the avoidance of computed tomography (CT), a source of ionizing radiation, renders US imaging desirable. Although currently paediatric CEUS is principally used in an "off-label" manner, US contrast agents have received regulatory approval for assessment of paediatric focal liver lesions in the United States of America...
September 9, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27575687/association-between-slow-and-delayed-graft-function-with-graft-outcomes-in-paediatric-and-adolescent-deceased-donor-kidney-transplant-recipients
#8
Wai H Lim, Stephen P McDonald, Sean E Kennedy, Nicholas Larkins, Germaine Wong
BACKGROUND AND OBJECTIVE: Delayed graft function (DGF) is associated with an increased risk of graft loss in adult kidney transplant recipients but the association remains inconsistent in pediatric recipients. The aim of this study is to examine the association between DGF and graft loss in pediatric and adolescent deceased donor kidney transplant recipients aged ≤21 years using Australia and New Zealand Dialysis and Transplant (ANZDATA) registry. METHODS: The associations between DGF status, overall and death-censored graft loss (DCGL) were examined using adjusted Cox regression analyses...
August 29, 2016: Transplantation
https://www.readbyqxmd.com/read/27568108/the-viability-of-transplanting-organs-from-donors-who-underwent-cardiopulmonary-resuscitation-a-systematic-review
#9
Stephen West, Jasmeet Soar, Clifton W Callaway
AIMS: To identify reports of patients who underwent cardiopulmonary resuscitation (CPR) prior to solid organ donation and compare recipient and organ function outcomes to those that did not undergo CPR. Donation after restoration of circulation then progressing to death and those donating with on-going CPR who would have otherwise have termination of efforts were both included. METHODS: Systematic review. Clinical studies comparing the outcome of patients and organs retrieved from donors who underwent CPR with those that did not require CPR...
August 24, 2016: Resuscitation
https://www.readbyqxmd.com/read/27313274/chronic-peritoneal-dialysis-in-chinese-infants-and-children-younger-than-two-years
#10
Y H Chan, A Lt Ma, P C Tong, W M Lai, N Kc Tse
OBJECTIVE: To review the outcome for Chinese infants and young children on chronic peritoneal dialysis. METHODS: The Paediatric Nephrology Centre of Princess Margaret Hospital is the designated site offering chronic dialysis to children in Hong Kong. Medical records of children who started chronic peritoneal dialysis before the age of 2 years, from 1 July 1995 to 31 December 2013, were retrieved and retrospectively reviewed. RESULTS: Nine Chinese patients (male-to-female ratio, 3:6) were identified...
August 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27306873/surveillance-biopsies-after-paediatric-kidney-transplantation-a-review
#11
REVIEW
Edward M Rose, Sean E Kennedy, Fiona E Mackie
Kidney transplantation is the most effective means of treating children with end-stage kidney disease, and yet, there continues to be a limited "life span" of transplanted kidneys in paediatric recipients. Early graft monitoring, using the surveillance biopsy, has the potential to extend renal allograft survival in paediatric recipients. The surveillance biopsy provides important and timely information about acute and chronic graft pathology, particularly SCR and calcineurin inhibitor-induced nephrotoxicity, which can subsequently guide management decisions and improve long-term graft survival...
September 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27195169/leiomyoma-in-a-renal-allograft
#12
Yan Jun Li, Amila Rohan Siriwardana, James Lawrence Penn Symons, Gordon Francis O'Neill, Min Ru Qiu, Timothy John Furlong
Leiomyomas are smooth muscle tumours that are rarely found in the kidney. There is one report of a leiomyoma in a kidney transplant in a paediatric recipient. Here, we report an adult renal transplant recipient who developed an Epstein-Barr virus-positive leiomyoma in his allograft 15 years after transplantation. The patient was converted to everolimus for posttransplant immunosuppression management and there was no sign of progression over a year.
2016: Case Reports in Urology
https://www.readbyqxmd.com/read/27184649/long-term-safety-in-living-kidney-donors-for-paediatric-transplantation-single-centre-prospective-study
#13
J Martin Benlloch, E Román Ortiz, S Mendizabal Oteiza
INTRODUCTION: There is enough evidence concerning the short-term safety of living donors after kidney transplantation. However, long-term complications continue to be studied, with a particular interest in young donors. Previous studies have been conducted in older donors for adult renal patients. We present a study of long-term complications in kidney donors for our paediatric population. METHODS: We carried out a long-term donor study for the 54 living kidney-donor transplantations performed at our department from 1979 to June 2014...
November 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27138785/the-effect-of-weight-and-cyp3a5-genotype-on-the-population-pharmacokinetics-of-tacrolimus-in-stable-paediatric-renal-transplant-recipients
#14
Agnieszka A Prytuła, Karlien Cransberg, Antonia H M Bouts, Ron H N van Schaik, Huib de Jong, Saskia N de Wildt, Ron A A Mathôt
BACKGROUND: The aim of this study was to develop a population pharmacokinetic model of tacrolimus in paediatric patients at least 1 year after renal transplantation and simulate individualised dosage regimens. PATIENTS AND METHODS: We included 54 children with median age of 11.1 years (range 3.8-18.4 years) with 120 pharmacokinetic profiles performed over 2 to 4 h. The pharmacokinetic analysis was performed using the non-linear mixed-effects modelling software (NONMEM(®))...
September 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27072744/late-onset-noninfectious-interstitial-lung-disease-following-autologous-haematopoietic-stem-cell-transplantation-in-paediatric-patients
#15
Yoon-Kyoung Lee, Rimm Huh, Jihyun Kim, Kangmo Ahn, Ki Woong Sung, Joongbum Cho
BACKGROUND AND OBJECTIVE: High-dose chemotherapy (HDCT) followed by autologous haematopoietic stem cell transplantation (HSCT) is widely used in paediatric cancer patients, but few data about noninfectious interstitial lung disease (ILD) following this treatment are available. Therefore, we aimed to evaluate the incidence, clinical features and risk factors of noninfectious ILD after HDCT in paediatric patients. METHODS: This was a retrospective cohort study of paediatric solid tumour patients who underwent HDCT and autologous HSCT between 1997 and 2012...
August 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27060472/single-centre-study-reports-a-84-five-year-overall-survival-rate-for-paediatric-solid-tumours
#16
Eero Teppo, Jarkko Penttinen, Outi Myöhänen, Kim Vettenranta, Olli Lohi
AIM: We investigated the characteristics and outcome of paediatric patients with solid tumours diagnosed and treated at the Tampere University Hospital, one of the five tertiary referral centres in Finland, for children and adolescents with malignancies. METHODS: This retrospective cohort study collected data from hospital medical records on survival, diagnosis, age, sex, tumour size and stage at diagnosis. We also observed the disease recurrence and use of autologous haematopoietic stem cell transplantation...
August 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/26991793/steroid-avoidance-or-withdrawal-regimens-in-paediatric-kidney-transplantation-a-meta-analysis-of-randomised-controlled-trials
#17
Huanxi Zhang, Yitao Zheng, Longshan Liu, Qian Fu, Jun Li, Qingshan Huang, Huijiao Liu, Ronghai Deng, Changxi Wang
BACKGROUND: We combined the outcomes of all randomised controlled trials to investigate the safety and efficacy of steroid avoidance or withdrawal (SAW) regimens in paediatric kidney transplantation compared with steroid-based (SB) regimens. METHODS: A systematic literature search of PubMed, Embase, Cochrane Library, the trials registry and BIOSIS previews was performed. A change in the height standardised Z-score from baseline (ΔHSDS) and acute rejection were the primary endpoints...
2016: PloS One
https://www.readbyqxmd.com/read/26912550/early-requirement-for-rrt-in-children-at-presentation-in-the-united-kingdom-association-with-transplantation-and-survival
#18
Rishi Pruthi, Anna Casula, Carol Inward, Paul Roderick, Manish D Sinha
BACKGROUND AND OBJECTIVES: We evaluated rates and factors associating with late referral (LR) and describe association of LR with access to renal transplantation and patient survival in children in the United Kingdom. Early requirement of RRT within 90 days of presentation to a pediatric nephrologist was classed as a LR, and those >90 days as an early referral (ER). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We included patients who commenced RRT, aged ≥3 months and <16 years, from 1996 to 2012...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26831913/kidney-disease-in-children-latest-advances-and-remaining-challenges
#19
REVIEW
John F Bertram, Stuart L Goldstein, Lars Pape, Franz Schaefer, Rukshana C Shroff, Bradley A Warady
To mark World Kidney Day 2016, Nature Reviews Nephrology invited six leading researchers to highlight the key advances and challenges within their specialist field of paediatric nephrology. Here, advances and remaining challenges in the fields of prenatal patterning, acute kidney injury, renal transplantation, genetics, cardiovascular health, and growth and nutrition, are all discussed within the context of paediatric and neonatal patients with kidney disease. Our global panel of researchers describe areas in which further studies and clinical advances are needed, and suggest ways in which research in these areas should progress to optimize renal care and long-term outcomes for affected patients...
March 2016: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/26802205/predictors-of-outcomes-in-children-awaiting-heart-transplantation-an-experience-from-a-national-paediatric-heart-transplantation-programme
#20
William Y Shi, Michael Rouse, Robert G Weintraub, Diana Zannino, Anne Shipp, Yves d'Udekem, Igor E Konstantinov
OBJECTIVES: The risk of mortality while awaiting heart transplantation (HT) may be greater in the setting of a smaller population and lower donor organ rates. Optimizing allocation policy and identifying the most vulnerable patients will help reduce mortality. As such, we aimed to evaluate the predictors of outcomes in patients awaiting HT as part of a National Paediatric HT Programme. METHODS: Between 1988 and 2015, 200 children were listed for HT as part of a National Paediatric HT Programme...
June 2016: European Journal of Cardio-thoracic Surgery
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