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Pediatric Heart Transplantation

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63 papers 0 to 25 followers
By Javier Castro Heart Failure And Heart Transplantation
Ivan Knezevic
No abstract text is available yet for this article.
December 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Zhaoyi Tang, Jon Kobashigawa, Matthew Rafiei, Lily Kagan Stern, Michele Hamilton
Purpose. The most recent International Society for Heart and Lung Transplantation (ISHLT) biopsy scale classifies cellular and antibody-mediated rejections. However, there are cases with acute decline in left ventricular ejection fraction (LVEF ≤ 45%) but no evidence of rejection on biopsy. Characteristics and treatment response of this biopsy negative rejection (BNR) have yet to be elucidated. Methods. Between 2002 and 2012, we found 12 cases of BNR in 11 heart transplant patients as previously defined. One of the 11 patients was treated a second time for BNR...
2013: Journal of Transplantation
Manchula Navaratnam, Ann Ng, Glyn D Williams, Katsuhide Maeda, Julianne M Mendoza, Waldo Concepcion, Seth A Hollander, Chandra Ramamoorthy
BACKGROUND: Combined heart and liver transplantation (CHLT) in the pediatric population involves a complex group of patients, many of whom have palliated congenital heart disease (CHD) involving single ventricle physiology. OBJECTIVE: The purpose of this study was to describe the perioperative management of pediatric patients undergoing CHLT at a single institution and to identify management strategies that may be used to optimize perioperative care. METHODS: We did a retrospective database review of all patients receiving CHLT at a children's hospital between 2006 and 2014...
October 2016: Paediatric Anaesthesia
Swati Sehgal, Matthew J Bock, Hannah Louks Palac, Wendy J Brickman, Jeffrey G Gossett, Bradley S Marino, Carl L Backer, Elfriede Pahl
Diabetes mellitus is a recognized complication of SOT in adults and is associated with decreased graft and patient survival. Little is known about NOD in pediatric HT recipients. We aimed to characterize the incidence and describe risk factors for development of NOD after HT in children. Children who developed diabetes after HT were identified from the OPTN database. Demographic and clinical data before and after transplant were compared between patients with and without NOD. A total of 2056 children were included, 56% were male, 54% were Caucasian, and 62% had cardiomyopathy prior to HT...
July 15, 2016: Pediatric Transplantation
Philip T Thrush, Elfriede Pahl, David C Naftel, Elizabeth Pruitt, Melanie D Everitt, Heather Missler, Steven Zangwill, Michael Burch, Timothy M Hoffman, Ryan Butts, William T Mahle
BACKGROUND: Current knowledge of antibody-mediated rejection (AMR) after heart transplantation (HT) stems largely from adult data. Using the Pediatric Heart Transplant Study (PHTS) database, we report the incidence of AMR, describe treatment, and evaluate outcomes for treated AMR in children after HT. METHODS: We queried the PHTS database for patients <18 years of age undergoing primary HT between January 2010 and December 2014. An AMR episode was defined as either a biopsy consistent with pathologic AMR or a rejection event based on immunotherapy augmentation directed against antibody production...
December 2016: Journal of Heart and Lung Transplantation
Joseph W Rossano, Antonio G Cabrera, Robert E Shaddy
OBJECTIVES: Although there have been tremendous advancements in the care of severe pediatric cardiovascular disease, heart transplantation remains the standard therapy for end-stage heart disease in children. As such, these patients comprise an important and often complex subset of patients in the ICU. The purpose of this article is to review the causes and management of allograft dysfunction and the medications used in the transplant population. DATA SOURCES: MEDLINE, PubMed, and Cochrane Database of systemic reviews...
August 2016: Pediatric Critical Care Medicine
Y-J Wang, N-H Chi, N-K Chou, S-C Huang, C-H Wang, I-H Wu, H-Y Yu, Y-S Chen, C-I Tsao, C-T Shun, J-T Tsai, S-S Wang
BACKGROUND: With advances in immunosuppressive therapy, heart transplantation is currently recommended as the only established surgical treatment for refractory heart failure. However, chronic immunosuppression increases the risk for malignancy. Everolimus (EVR) is a potent mammalian target of rapamycin inhibitor that is used after transplantation and to treat advanced malignancies, as we have done in Taiwan after heart transplantation since 2004. Mycophenolate mofetil (MMF) and EVR are frequently used as cell-cycle inhibitors to optimize post-transplantation outcomes...
April 2016: Transplantation Proceedings
Regi Freeman, Erika Koerner, Courtney Clark, Kathy Halabicky
Heart failure is a progressive and fatal disease impacting millions of American each year. Divided into stages, heart failure presents with progressive symptoms requiring a wide range of medical treatments. Treatments include diet and lifestyle changes, medications, electrical therapies (defibrillator and/or cardiac resynchronization therapy), as well as mechanical circulatory support. Cardiac transplant is the gold standard treatment of heart failure, although the availability of donors limits the utility of a cardiac transplant...
July 2016: Critical Care Nursing Quarterly
Regi Freeman, Erika Koerner, Courtney Clark, Kathy Halabicky
Heart failure impacts a multitude of individuals each year. Treatment is based on the progression of the disease and severity of symptoms. Cardiac transplant is the gold standard treatment of advanced heart failure, although the availability of organs limits the number of transplants received each year. Postoperative care and monitoring for cardiac transplant is complex and requires specialized nurses and providers at transplant centers for successful outcomes. This article outlines cardiac transplant from preoperative care through transplant, as well as posttransplant monitoring and care including discharge...
July 2016: Critical Care Nursing Quarterly
Erin M Schumer, Matthew C Black, Michael P Rogers, Jaimin R Trivedi, Emma J Birks, Andrew J Lenneman, Allen Cheng, Mark S Slaughter
Donor to recipient undersizing can result in diminished graft survival. The United Network for Organ Sharing database was retrospectively queried from January 2008 to December 2013 to identify adult patients who underwent heart transplantation. This population was divided into those without and with a left ventricular assist device (LVAD) at the time of transplant. Both groups were further subdivided into three groups: donor:recipient body mass index (BMI) ratio <0.8 (undersized), ≥0.8 and ≤1.2 (matched), and >1...
September 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Mariel E Turner, Linda J Addonizio, Marc E Richmond, Warren A Zuckerman, Julie A Vincent, Alejandro J Torres, Michael B Collins
OBJECTIVES: To describe our experience, at a large pediatric heart transplant center, with percutaneous coronary interventions (PCI) for cardiac allograft vasculopathy (CAV). BACKGROUND: CAV is a leading cause of late graft failure, mortality, and re-transplantation in pediatric heart transplant (HTx) recipients. Studies of PCI in adult patients have shown some short-term improvements, but no significant change in long-term outcomes. There are limited data on PCI for CAV in pediatric patients...
April 16, 2016: Catheterization and Cardiovascular Interventions
Jonathan N Flyer, Warren A Zuckerman
No abstract text is available yet for this article.
August 2016: Pediatric Transplantation
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
Ilkay Erdogan, Birgul Varan, Atilla Sezgin, Arash Pirat, Pinar Zeyneloglu
OBJECTIVES: Humoral rejection is the B-cell-mediated production of immunoglobulin G antibody against the transplanted heart. Antibody-mediated rejection may be resistant to standard immunosuppressive therapy and is associated with high mortality and graft loss. Rituximab can be used to treat antibody-mediated rejection in heart transplant recipients. This retrospective study describes our experience with rituximab treatment in children with heart transplants. MATERIALS AND METHODS: We present 7 pediatric patients with antibody-mediated rejection who were treated with plasma exchange and rituximab therapy...
May 17, 2016: Experimental and Clinical Transplantation
Jimmy C Lu, H Sonali Magdo, Sunkyung Yu, Ray Lowery, Ranjit Aiyagari, Mary Zamberlan, Robert J Gajarski
In pediatric heart transplant recipients, elevated pulmonary capillary wedge pressure (PCWP) is associated with rejection and coronary artery vasculopathy. This study aimed to evaluate which echocardiographic parameters track changes in PCWP and predict adverse outcomes (rejection or coronary artery vasculopathy). This prospective single-center study enrolled 49 patients (median 11.4 years old, interquartile range 7.4 to 16.5) at time of cardiac catheterization and echocardiography. Median follow-up was 2.4 years (range 1...
May 1, 2016: American Journal of Cardiology
Conall T Morgan, Cedric Manlhiot, Brian W McCrindle, Anne I Dipchand
BACKGROUND: In the registry of the International Society for Heart and Lung Transplantation (ISHLT), cerebrovascular accidents are the fifth most common cause for mortality after pediatric heart transplantation (PHTx), but details are lacking in the literature. The purpose of this analysis of the ISHLT registry was to determine the prevalence, risk factors and outcomes of stroke after PHTx. METHODS: Data from the ISHLT registry (1998 to 2010) were used to identify all patients whose primary transplantation was performed at <18 years of age...
May 2016: Journal of Heart and Lung Transplantation
Sean M Lang, Elizabeth A Frazier, R Thomas Collins
Aortic complications occur rarely after pediatric orthotopic heart transplantation, but are typically accompanied by catastrophic events. We describe the three cases of major aortic complications in our experience of 329 pediatric heart transplants. This case series and review highlight the important risk factors for aortic complications after heart transplantation.
January 2016: Annals of Pediatric Cardiology
Kirk R Kanter
Previous studies have reported that children with a prior Fontan procedure have decreased survival after heart transplantation. We examined 273 primary pediatric heart transplants. Since 1988, 33 (12.1%) of 273 children <18 years old undergoing primary heart transplantation had a Fontan procedure 3.7 ± 4.3 years before transplantation. Compared with 240 (87.9%) non-Fontan primary transplants, the Fontan patients were older (8.8 ± 5.2 vs 6.6 ± 5.9 years; P = .023), but were similar in presensitization and pre-transplant clinical status...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Rakesh K Singh, Timothy Humlicek, Aamir Jeewa, Keith Fester
OBJECTIVE: In this Consensus Statement, we review the etiology and pathophysiology of inflammatory processes seen in critically ill children with cardiac disease. Immunomodulatory therapies aimed at improving outcomes in patients with myocarditis, heart failure, and transplantation are extensively reviewed. DATA SOURCES: The author team experience and along with an extensive review of the medical literature were used as data sources. DATA SYNTHESIS: The authors synthesized the data in the literature to present current immumodulatory therapies...
March 2016: Pediatric Critical Care Medicine
Mandeep R Mehra, Charles E Canter, Margaret M Hannan, Marc J Semigran, Patricia A Uber, David A Baran, Lara Danziger-Isakov, James K Kirklin, Richard Kirk, Sudhir S Kushwaha, Lars H Lund, Luciano Potena, Heather J Ross, David O Taylor, Erik A M Verschuuren, Andreas Zuckermann
No abstract text is available yet for this article.
January 2016: Journal of Heart and Lung Transplantation
2016-02-03 21:51:53
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