Adina Landsberg, S Sikandar Raza, Michael E Seifert, Tom D Blydt-Hansen
BACKGROUND: Incomplete resolution of T cell-mediated rejection (TCMR) after treatment may not be detected with serum creatinine monitoring and is associated with donor-specific antibodies and chronic rejection. We evaluate the utility of follow-up biopsies (FUB) to identify and characterize rates of persistent TCMR after treatment in pediatric kidney transplant patients. METHODS: Patients from two pediatric transplant centers performing standard of care FUB at 1...
September 26, 2023: Pediatric Transplantation
Brian Condran, Melissa Kervin, Catherine Burton, Tom D Blydt-Hanson, Shaun K Morris, Manish Sadarangani, Anthony Otley, Elaine Yong, Hana Mitchell, Julie A Bettinger, Karina A Top
BACKGROUND: Live attenuated varicella vaccine (LAVV) has historically been contraindicated in children who are immunocompromised due to solid organ transplant (SOT) because of safety concerns. Recently, clinical guidelines were developed that support post-transplant varicella vaccination in selected SOT recipients based on emerging evidence of LAVV safety. This qualitative study sought to explore barriers and facilitators to implementing the new guidelines, as well as acceptability of LAVV among healthcare providers (HCPs) and parents...
September 25, 2023: Pediatric Transplantation
Amber Hager, Yuxin Guo, Yiqi Wang, Vera Mazurak, Susan M Gilmour, Diana R Mager
BACKGROUND: In adult transplant (Tx) populations, exercise rehabilitation strategies may improve sarcopenia components (muscle mass [MM], strength [MS], and physical performance [PP]). Limited data are available regarding exercise rehabilitation therapy in pediatric Tx populations. METHODS: The purpose of this review is to critically evaluate the feasibility and impact of exercise programs (EP) that include resistance exercise (RE) on markers of sarcopenia in pediatric Tx populations...
September 25, 2023: Pediatric Transplantation
Xinyi Huang, Katherine Hapgood, Kari Allan, Cozumel Pruette, Elizabeth Goswami
BACKGROUND: Published data on LCP-tacrolimus (LCPT) in the pediatric population are limited. METHODS: This single-center, retrospective, observational study describes LCPT doses needed to reach therapeutic ranges in pediatric and young adult kidney and liver transplant recipients in both de novo usage and conversion from immediate-release tacrolimus (IR-Tac). Adverse outcomes up to 12 months after LCPT initiation were also evaluated. RESULTS: Forty-one transplant recipients (30 kidney, 11 liver) were included...
September 21, 2023: Pediatric Transplantation
Bethany L Wisotzkey, Byron Jaeger, Alfred Asante-Korang, Molly Brickler, Ryan S Cantor, Melanie D Everitt, James K Kirklin, Devin Koehl, Benjamin S Mantell, Philip T Thrush, Micheal Kuhn
BACKGROUND: Pediatric heart transplant patients are at greatest risk of allograft loss in the first year. We assessed whether machine learning could improve 1-year risk assessment using the Pediatric Heart Transplant Society database. METHODS: Patients transplanted from 2010 to 2019 were included. The primary outcome was 1-year graft loss free survival. We developed a prediction model using cross-validation, by comparing Cox regression, gradient boosting, and random forests...
September 19, 2023: Pediatric Transplantation
Maria Meneghini, Anat Roitberg Tambur
Kidney transplantation is the treatment of choice for children with end-stage kidney failure, yet suboptimal outcomes, the need for long-term immunosuppression, and the dependency on consecutive transplants pose significant barriers to success. Providing better HLA-matched organs to pediatric patients seems to be the most logical approach to improve graft and patient outcomes and to reduce risk of anti-HLA sensitization after graft failure. We here review recent literature on HLA matching in pediatric kidney transplantation...
September 16, 2023: Pediatric Transplantation
Duygu Kaba, Burcu Akın Sarı, Hande Ayraler Taner
BACKGROUND: Adjustment disorder (AD) in individuals suffering from end-stage organ failure can negatively impact treatment adherence and overall quality of life. Previous research focusing on adults has suggested that AD might serve as a precursor to major mental disorders. However, although it is frequently used as a diagnosis in consultation-liaison psychiatry, our understanding of AD in pediatric transplant candidates remains limited. Therefore, the objective of this study is to assess AD and identify its associated risk factors among children who are candidates for heart, kidney, and liver transplantation...
September 16, 2023: Pediatric Transplantation
Nina Zook, Lisa Schultz, Sandra Rizzuto, Amanda Aufdermauer, Amanda M Hollander, Christopher S Almond, Seth A Hollander
BACKGROUND: Tube feeds are used commonly in children listed for heart transplant; however, rates of renourishment and development of feeding disorders are not sufficiently characterized. METHODS: Retrospective review of pediatric heart transplant recipients from January 1, 2014, to January 3, 2021. Demographics, anthropometric, and nutritional data were collected from heart transplant listing through 3 years post-transplant. Renourishment rates, presence of a feeding disorder, and need for a gastric feeding tube were analyzed...
September 14, 2023: Pediatric Transplantation
Alicia M Kamsheh, Charles E Canter
No abstract text is available yet for this article.
September 14, 2023: Pediatric Transplantation
Rachel M Engen, Samantha Weiss, Caitlin G Peterson
BACKGROUND: The 2014 Kidney Allocation System (KAS) introduced longevity matching for adult candidates using the Estimated Post-Transplant Survival (EPTS) score, which includes candidate age, time on dialysis, diabetes status, and number of previous solid organ transplants. The proposed continuous distribution framework may expand the use of this attribute to pediatric candidates, but there is no data on its performance among pediatric kidney transplant recipients. METHODS: We performed a retrospective cohort study of 6800 pediatric kidney transplant recipients from 2001 to 2011 using Organ Procurement and Transplantation Network (OPTN) data...
September 12, 2023: Pediatric Transplantation
Joseph Reis, Aaron M Bogart, Patrick J Healey, Andre A S Dick
BACKGROUND: Renal vein stenosis is uncommon following transplantation. We report acute renal vein stenosis post-transplant treated with an endovascular stent and complicated by urinary obstruction from clot formation. METHODS: Retrospective case report. RESULTS: A 16-year-old female 3 years post-transplant suffered anuria post-stenting with renal ultrasound demonstrating obstructive clot in the collecting system, a previously unreported complication...
September 11, 2023: Pediatric Transplantation
Hyun Ah Woo, Seong Heon Kim, Yo Han Ahn, Sang Il Min, Jongwon Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
BACKGROUND: Schimke immuno-osseous dysplasia (SIOD) is a rare systemic disease characterized by short stature, proteinuria, and recurrent infections. Patients usually have spondyloepiphyseal dysplasia, and progressive steroid-resistant nephropathy that leads to kidney failure. However, their clinical course after kidney transplantation (KT) is not yet well known. Here, we present our experience with cases of SIOD treated at our institute. CASE PRESENTATION: Since 2014, three children have been diagnosed with nephropathy resulting from SIOD...
September 11, 2023: Pediatric Transplantation
Anu K Vasudevan, Naresh Shanmugam, Ashwin Rammohan, Joseph J Valamparampil, Kshetra Rinaldhy, Jagadeesh Menon, Ravikumar Thambithurai, Saravanapandian Namasivayam, Ilankumaran Kaliamoorthy, Mohamed Rela
BACKGROUND: Progressive familial intrahepatic cholestasis (PFIC) is a heterogenous group of inherited hepatocellular disorders and the clinical aspects, role of liver transplantation (LT), and its outcomes remain largely unelucidated. We present our data of LT for each type of PFIC and compare their early, and long-term outcomes, highlighting their individual differences and management strategies. METHODS: Prospectively collected data over a decade (2011-2022) of children with PFIC who underwent LT was analyzed...
September 7, 2023: Pediatric Transplantation
Matthew J O'Connor
No abstract text is available yet for this article.
September 4, 2023: Pediatric Transplantation
Olivia Lullmann, Ellen van der Plas, Lyndsay A Harshman
BACKGROUND: Chronic kidney disease (CKD) is a relatively rare childhood disease that is associated with a wide array of medical comorbidities. Roughly half of all pediatric patients acquire CKD due to congenital anomalies of the kidneys and urinary tract, and of those with congenital disease, 50% will progress to end-stage kidney disease (ESKD) necessitating a kidney transplantation. The medical sequelae of advanced CKD/ESKD improve dramatically following successful kidney transplantation; however, the impact of kidney transplantation on neurocognition in children is less clear...
September 4, 2023: Pediatric Transplantation
Vikram Kumar, Vipul Gautam, Shaleen Agarwal, Vijaykant Pandey, Sumit Goyal, Vaibhav Nasa, Shweta A Singh, Khalid Al-Thihli, Fathiya Al-Murshedi, Nadia Al Hashmi, Yusriya Al Rawahi, Al-Qasim Al-Bahlani, Khoula Al Said, Subhash Gupta
BACKGROUND: Domino liver transplant (DLT) represents another type of liver donor to expand the donor pool. Recent reports of successful DLT in children with maple syrup urine disease (MSUD) show promising long-term outcomes. METHODS: It was a retrospective study. All children with MSUD were paired with either recipients with end-stage liver disease (ESLD) or non-MSUD metabolic disease. Each pair underwent simultaneous liver transplant (LT), where the MSUD recipient received the graft from a living-related donor and the liver explanted from the MSUD donor was transplanted to the respective paired domino recipient...
September 1, 2023: Pediatric Transplantation
David J Roach, Nick A Szugye, Ryan A Moore, Md Monir Hossain, David L S Morales, Don Hayes, Christopher T Towe, Farhan Zafar, Jason C Woods
RATIONALE: Organ size matching is an important determinant of successful allocation and outcomes in lung transplantation. While computed tomography (CT) is the gold standard, it is rarely used in an organ-donor context, and chest X-ray (CXR) may offer a practical and accurate solution in estimating lung volumes for donor and recipient size matching. We compared CXR lung measurements to CT-measured lung volumes and traditional estimates of lung volume in the same subjects. METHODS: Our retrospective study analyzed clinically obtained CXR and CT lung images of 250 subjects without evidence of lung disease (mean age 9...
September 1, 2023: Pediatric Transplantation
Srinath Chinnakotla, Carlos Esquivel, Katherine Twombley, Klara Posfay-Barbe, Sheri M Krams
The 12th Congress of the (IPTA) event in Austin, Texas, had over 400 attendees from 40 countries. The attendees included a diverse mix of pediatric transplant professionals from several specialties including physicians, surgeons, scientists, nurses, organ procurement personnel, advance transplant providers, pharmacists, administrators, fellows, residents, and students. The 4-day event featured nearly 200 abstracts, 90 oral presentations, 24 mini oral presentations, and more than 80 poster presentations. All of these presentations encouraged vibrant discussions and supported the exchange of new clinical and basic science information regarding clinical care management, basic science research, socioeconomic, and ethical and organ donation issues relevant to pediatric transplantation...
August 25, 2023: Pediatric Transplantation
Aaron Wightman
No abstract text is available yet for this article.
August 22, 2023: Pediatric Transplantation
Irene D Lytrivi, Devin Koehl, Paul Esteso, Erik L Frandsen, Meredith K Gibbons, James K Kirklin, Ryan Cantor, Jacqueline M Lamour, Adam Putschoegl, Svetlana Shugh, Ryan J Williams, F Bennett Pearce
BACKGROUND: A positive crossmatch (+ XM) has traditionally been associated with adverse outcomes following pediatric heart transplantation. However, more recent studies suggest that favorable intermediate-term outcomes may be achieved despite a + XM. This study's hypothesis is that children with a + XM have similar long-term survival, but higher rate of complications such as rejection, coronary allograft vasculopathy (CAV), and infection, compared to patients with a negative (-) XM. METHODS: The Pediatric Heart Transplant Society Registry (PHTS) database was queried from 2010-2021 for all patients <18 years of age with a known XM...
August 21, 2023: Pediatric Transplantation
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