Jessica M Winters, Rebecca Brocks, Catherine A Chapin, Caroline P Lemoine, Riccardo Superina, Katherine A Brandt, L Nelson Sanchez-Pinto, Matthew F Barhight
BACKGROUND: Positive fluid balance (FB) is associated with poor outcomes in critically ill children but has not been studied in pediatric liver transplant (LT) recipients. Our goal is to investigate the relationship between postoperative FB and outcomes in pediatric LT recipients. METHODS: We performed a retrospective cohort study of first-time pediatric LT recipients at a quaternary care children's hospital. Patients were stratified into three groups based on their FB in the first 72 h postoperatively: <10%, 10-20%, and > 20%...
March 23, 2023: Pediatric Transplantation
D E Dulek, M I Ardura
No abstract text is available yet for this article.
March 22, 2023: Pediatric Transplantation
Rochelle Liverman, Anastacia Serluco, Gwen Nance, Roshan George, Dellys Soler Rodriguez, Shriprasad Deshpande, Chad Mao, Rouba Garro, Inci Yildirim
BACKGROUND: Cytomegalovirus (CMV) is associated with morbidity and mortality in solid organ transplant recipients (SOTR). Valganciclovir (VGC) is extensively used for prophylaxis. Optimal dosing in children, risk factors for failure, and the impact of dose adjustments on CMV DNAemia is not well established. METHODS: This retrospective cohort study of pediatric SOTR transplanted between 2010-2018 evaluated the epidemiology of CMV DNAemia and used Cox-regression to assess the risk factors for CMV DNAemia within one-year following SOTR...
March 21, 2023: Pediatric Transplantation
Gretchen B Chapman, Alison Butler, Mandy Lanyon, Justin Godown, Daniel J Lebovitz
BACKGROUND: Children awaiting transplantation face a high risk of waitlist mortality due to a shortage of pediatric organ donors. Pediatric donation consent rates vary across Organ Procurement Organizations (OPOs), suggesting that some OPOs might utilize more effective pediatric-focused donor recruitment techniques than others. An online survey of 193 donation requestor staff sheds light on the strategies that OPO staff utilize when approaching potential pediatric deceased organ donors...
March 21, 2023: Pediatric Transplantation
Amy G Feldman, Brenda Beaty, Melanie Everitt, Jens Goebel, Allison Kempe, Lauren Pratscher, Lara A Danziger-Isakov
BACKGROUND: COVID-19 vaccine is recommended for individuals ages ≥6 months; however, whether vaccination should be mandated for transplant candidates and living donors remains controversial. This study assessed COVID-19 policies at US pediatric solid organ transplant centers. METHODS: A 79-item survey was emailed between March and April 2022 to 200 UNOS Medical Directors detailing center COVID-19 vaccine policies for transplant candidates and living donors and use of grafts from COVID-19-positive deceased donors...
March 20, 2023: Pediatric Transplantation
Aviva Goldberg
No abstract text is available yet for this article.
March 20, 2023: Pediatric Transplantation
Irini Batsis, Scott Elisofon, Michael Ferguson, Maureen Jonas, Brendan Kimball, Christine Lee, Paul Mitchell, Rima Fawaz
BACKGROUND: Chronic kidney disease (CKD) impacts long-term morbidity in pediatric liver transplant (LT) recipients. The prevalence of estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 (eGFR < 90) at our institution was 25% at 1 year post-LT; thus, quality improvement (QI) project was initiated, aiming to decrease the prevalence of eGFR < 90 by at least 20% at 1 year-post LT. METHODS: Children post-LT under 19 years from 2010 to 2018 were included...
March 20, 2023: Pediatric Transplantation
Olivia Lullmann, Amy L Conrad, Emily J Steinbach, Tammy Wilgenbusch, Lyndsay A Harshman, Ellen van der Plas
BACKGROUND: Pediatric chronic kidney disease (CKD) patients are at risk for cognitive deficits with worsening disease progression. Limited, existing cross-sectional studies suggest that cognitive deficits may improve following kidney transplantation. We sought to assess cognitive performance in relationship to kidney transplantation and kidney-specific medical variables in a sample of pediatric kidney transplant patients who provided cross-sectional and longitudinal observations. METHODS: A retrospective chart review was conducted in patients who completed pre- and/or post-transplant neurocognitive testing at the University of Iowa from 2015-2021...
March 17, 2023: Pediatric Transplantation
Natasha Su Lynn Ng, Sellathurai Gajendran, Nicholas Plant, Mohan Shenoy
BACKGROUND: Early steroid withdrawal (ESW) improves growth following kidney transplant (KT). It is not known whether these children achieve target height within mid-parental height range post-KT. METHODS: Retrospective analysis of growth patterns of KT recipients following ESW in our center between 2009 and 2020 had minimum follow-up period of 12 months. RESULTS: Forty-eight (female 29.2%) KT recipients, median age 5.3 years at first KT, were included...
March 15, 2023: Pediatric Transplantation
Ersin Toret, Zeynep Canan Ozdemir, Gizem Zengin Ersoy, Cigdem Oztunali, Ceyhun Bozkurt, Rejin Kebudi
BACKGROUND: Retinoblastoma (RB) is the most common intraocular malignancy in childhood. Advanced RB, associated with exceedingly poor prognosis, requires more intensive multiagent chemotherapy than conventional regimens. Rescue of the bone marrow after intensive chemotherapy is achieved with stem cell transplantation. The sequential courses (tandem transplantation) of high-dose chemotherapy followed by autologous stem cell transplantation allow for even greater dose intensity in consolidation with the potential to use different active chemotherapeutics at each transplant and have proven feasible and successful in treating children with recurrent/refractory solid tumors...
March 15, 2023: Pediatric Transplantation
Michael E Rogers, Teresa Ambrosino, Laura Hatcher, Alex Bondoc, Greg Tiao, Anna L Peters
BACKGROUND: Tacrolimus (TAC)-mediated renal disease occurs in up to 70% of pediatric liver transplant (LT) recipients. The safety and efficacy of renal-sparing immunosuppression using anti-thymocyte globulin (ATG) induction and delayed TAC administration has not been studied in children. We evaluated the safety and efficacy of ATG induction on preserving renal function in children within the first year (Y1) post-LT in a single-center retrospective cohort study. METHODS: Children under age 18 years of who received isolated LT from 2008 to 2020 with a GFR < 70 received renal-sparing (RS) protocol consisting of ATG with methylprednisolone (MP), delayed TAC administration, lower initial TAC trough goals, and mycophenolate mofetil (MMF)...
March 15, 2023: Pediatric Transplantation
Regina Gabriela Garcia Rheda, Aline Maria Luiz Pereira, José Medina Pestana, Paulo Cesar Koch Nogueira
BACKGROUND: In children with kidney failure, the longer the duration of dialysis the greater the impact on growth deficit, quality of life, and life expectancy. The aim of this research is to test whether there was a shortening of treatment time from kidney failure to transplantation in pediatric patients and whether this time interval impacted height. METHODS: Observational retrospective cohort study from 2005 to 2018. The first outcome variable was time to transplantation in years, while the second was height/age standard deviation score (SDS) at transplantation...
March 15, 2023: Pediatric Transplantation
Victoria A Statler, Thomas Fox, Monica I Ardura
BACKGROUND: Low-vaccination rates worldwide have led to the re-emergence of vaccine-preventable infections, including measles. Immunocompromised patients, including pediatric solid organ transplant (SOT) recipients, are at risk for measles because of suboptimal vaccination, reduced or waning vaccine immunity, lifelong immunosuppression, and global re-emergence of measles. OBJECTIVES: To review published cases of measles in pediatric SOT recipients to heighten awareness of its clinical manifestations, summarize diagnostic and treatment strategies, and identify opportunities to optimize prevention...
March 15, 2023: Pediatric Transplantation
Guillaume Rossignol, Xavier Muller, Remi Dubois, Agnes Rode, Jean-Yves Mabrut, Kayvan Mohkam
BACKGROUND: Graft-recipient size matching is a major challenge in pediatric liver transplantation, especially for adolescent recipients. Indeed, adolescents have the lowest transplantation rate among pediatric recipients, despite prioritization policies and the use of split grafts. In case of an important graft-recipient size mismatch, ex situ graft reduction with right posterior sectionectomy (RPS) may optimize the available donor pool to benefit adolescent recipients. METHODS: We present three cases of liver graft reduction with ex situ RPS for adolescent recipients...
March 15, 2023: Pediatric Transplantation
Pedro Carpini de Oliveira, Maria Julia de Aro Braz Corbi, Adailson Wagner da Silva Siqueira, Joshua Navajasegaran, Ana Sofia Silva Mesquita, Fernando Pereira Frassetto, Marcelo Bisceglli Jatene, Nana Miura Ikari, Estela Azeka
INTRODUCTION: Heart transplantation is the standard treatment for end-stage heart disease. Despite advances in the field, patients remain under risk of developing complications, including opportunistic infections, such as tuberculosis. We present the unprecedented case of cerebral tuberculoma in a 9-year-old heart transplant recipient. CASE SCENARIO: A 9-year-old female child, who underwent heart transplantation in December 2020, was admitted to the emergency department in September 2021 due to headache and vomiting...
March 14, 2023: Pediatric Transplantation
Fabiana Di Stasio, Michela Bravi, Sonia Bonanomi, Adriana Balduzzi, Giulia Prunotto, Guglielmo Marco Migliorino, Carlo Dufour, Lorenzo D'Antiga, Francesca Vendemini
BACKGROUND: In Fanconi anemia bone marrow failure is the major cause of morbidity and mortality and hematopoietic stem cell transplantation represents the only curative treatment. Liver disease, in terms of elevated liver function tests, as well as benign and malignant liver tumors, occurs especially in case of androgen treatment. We report a unique case of a child with Fanconi anemia with FANCD2 mutation who developed neonatal cryptogenic liver cirrhosis and bone marrow failure. The child successfully underwent sequential liver transplantation and hematopoietic stem cell transplantation in the first 2 years of life...
March 13, 2023: Pediatric Transplantation
Zhuyuan Si, Dongyan Lu, Lili Zhai, Weiping Zheng, Chong Dong, Chao Sun, Kai Wang, Wei Zhang, Xinzhe Wei, Zhixin Zhang, Shengqiao Zhao, Wei Gao, Zhongyang Shen
BACKGROUND: Posttransplant lymphoproliferative disease (PTLD) is a serious complication after pediatric liver transplantation (pLT), which may lead to death. 18 F-FDG PET/CT is rarely considered in PTLD after pLT and lacks clear diagnostic guidelines, especially in the differential diagnosis of nondestructive PTLD. The aim of this study was to find a quantifiable 18 F-FDG PET/CT index to identify nondestructive PTLD after pLT. METHODS: This retrospective study collected the data of patients who underwent pLT, postoperative lymph node biopsy, and 18 F-FDG PET/CT at Tianjin First Central Hospital from January 2014 to December 2021...
March 11, 2023: Pediatric Transplantation
Emily J Steinbach, Gina M Barletta, Hiren P Patel, David K Hooper, Rouba Garro, Lyndsay A Harshman
BACKGROUND: Kidney transplantation (KT) is the preferred treatment for children with end-stage kidney disease. Recent advances in immunosuppression and advances in donor specific antibody (DSA) testing have resulted in prolonged allograft survival; however, standardized approaches for surveillance DSA monitoring and management of de novo (dn) DSA are widely variable among pediatric KT programs. METHODS: Pediatric transplant nephrologists in the multi-center Improving Renal Outcomes Collaborative (IROC) participated in a voluntary, web-based survey between 2019 and 2020...
March 10, 2023: Pediatric Transplantation
David Blitzer, Seth Lirette, Lauren Kane, Jack G Copeland, David A Baran, Hannah Copeland
OBJECTIVES: There is limited data examining donor vasopressor and/or inotrope medications (vasoactives) on pediatric orthotopic heart transplant (OHT) outcomes. We aim to evaluate the effects of vasoactives on pediatric OHT outcomes. METHODS: The United Network for Organ Sharing database was retrospectively reviewed from January 2000 to March 2018 for donor hearts. Exclusion criteria included multiorgan transplants and recipient age >18. Donors receiving vasoactives at the time of procurement were compared to donors not on vasoactives, including the number of vasoactives and the type...
March 10, 2023: Pediatric Transplantation
Bianca R Campagna, Rachel A Annunziato
BACKGROUND: Understanding the role of substance use is important in the equitable allocation of solid organs and may present an opportunity for improving outcomes among substance users who receive transplants. This scoping review presents findings related to substance use among pediatric and young adult transplant populations and suggests future directions. METHODS: A scoping review was conducted seeking studies related to substance use in pediatric and young adult transplant populations under the age of 39 years...
March 9, 2023: Pediatric Transplantation
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