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Pediatric AND liver AND transplant

Pusen Wang, Weitao Que, Mingman Zhang, Xiaoke Dai, Kanru Yu, Chunguang Wang, Zhihai Peng, Lin Zhong
BACKGROUND & AIMS: Three-dimensional (3D) printing has been used to support organ translations. However, whether it helps remains unclear. This study aimed to present and assess the application of 3D printed liver models in pediatric living donor liver transplantation (LDLT). METHODS: 3D images were printed to touchable liver models with transparent liver parenchyma, specific colored hepatic vessels, and biliary structures. A total of 30 consecutive recipients were enrolled into the study, 10 were operated with the support of 3D printing (3D printing group) and 20 (Control group) without...
February 15, 2019: Liver Transplantation
Catherine A Chapin, Simon P Horslen, James E Squires, Henry Lin, Niviann Blondet, Saeed Mohammad, Estella M Alonso
OBJECTIVE: To examine the characteristics and outcomes of a multicenter patient cohort with indeterminate pediatric acute liver failure (IND-PALF) and with aplastic anemia with acute hepatitis treated with corticosteroids. STUDY DESIGN: Retrospective study of patients age 1-17 years with IND-PALF and aplastic anemia with acute hepatitis who presented between 2009 and 2018 to 1 of 4 institutions and were treated with corticosteroids for presumed immune dysregulation...
February 12, 2019: Journal of Pediatrics
Sergey Gautier, Artem Monakhov, Igor Miloserdov, Sergey Arzumanov, Olga Tsirulnikova, Konstantin Semash, Timur Dzhanbekov
With the presence of organ shortage, living donors remain important sources of grafts, especially for pediatric recipients. Laparoscopic nephrectomy has become the gold standard for living donors. Additionally, laparoscopic partial liver procurement in living donors has proven its safety and feasibility in the latest studies. We have combined both approaches to perform a simultaneous liver-kidney transplantation in a pediatric patient from the same living donor. Our experience of laparoscopic left lateral sectionectomy and laparoscopic nephrectomy in living donors was the basis for adapting to this procedure...
February 15, 2019: American Journal of Transplantation
Aabha Nagral, Moinak S Sarma, John Matthai, Prashanth L Kukkle, Harshad Devarbhavi, Sanjib Sinha, Seema Alam, Ashish Bavdekar, Radha K Dhiman, Chundamannil E Eapen, Vinay Goyal, Neelam Mohan, Rukmini M Kandadai, Malathi Sathiyasekaran, Ujjal Poddar, Anupam Sibal, Srinivas Sankaranarayanan, Anshu Srivastava, Baburam R Thapa, Pettarusp M Wadia, Surendra K Yachha, Anil Dhawan
Clinical practice guidelines for Wilson's disease (WD) have been published by the American Association for the Study of Liver Diseases and European Association for the Study of the Liver in 2008 and 2012, respectively. Their focus was on the hepatic aspects of the disease. Recently, a position paper on pediatric WD was published by the European Society of Pediatric Gastroenterology Hepatology and Nutrition. A need was felt to harmonize guidelines for the hepatic, pediatric, and neurological aspects of the disease and contextualize them to the resource-constrained settings...
January 2019: Journal of Clinical and Experimental Hepatology
Einar Hafberg, Scott C Borinstein, Sophoclis P Alexopoulos
PURPOSE OF REVIEW: Hepatoblastoma is the most common primary pediatric liver malignancy. The goal of treatment in hepatoblastoma is complete surgical resection. Recently published multinational collaborative studies are better defining risk factors for disease recurrence and guide optimal treatment strategy. RECENT FINDINGS: Successful margin-negative resection of hepatoblastoma is dependent on the location and extent of disease as defined by the PRETEXT classification...
February 11, 2019: Current Opinion in Organ Transplantation
Steven L Rathgeber, Kevin C Harris
The growing awareness of Fontan-associated liver disease (FALD) in adults with Fontan physiology has provided the impetus to better understand the natural history of FALD and develop a reliable noninvasive method to diagnose and monitor liver health in this population. Biochemical and imaging tests have been investigated to determine their association with liver pathology. The congestive hepatopathy that develops after the Fontan procedure has made interpreting these tests challenging. We have reviewed and summarized the current understanding and ongoing challenges with respect noninvasive measures of liver health in Fontan patients including biochemical tests, elastography, hepatic ultrasound, cross-sectional imaging, and hemodynamics and how they relate to liver pathology...
February 2019: Canadian Journal of Cardiology
Kai Wang, Zhuo-Lun Song, Bin Wu, Chun-Lei Zhou, Wei Liu, Wei Gao
Th17 and imbalance of Treg/Th17 might be one of the mechanisms of acute rejection. We aim to explore the role of Th17s in the balance of Treg/Th17 in acute rejection after LT in children diagnosed with BA. The ratios of Treg and Th17 in peripheral blood were detected by flow cytometry pre-LT, post-LT, and when rejection occurred. Treg proportion was higher before transplantation than at 2 weeks and 1 month after transplantation, with no statistical difference between 2 weeks and 1 month. However, Treg proportions were lower in pediatric recipients than healthy controls...
February 12, 2019: Pediatric Transplantation
Anette Melk, Birgit Babitsch, Bianca Borchert-Mörlins, Frans Claas, Anne I Dipchand, Sandra Eifert, Britta Eiz-Vesper, Jelena Epping, Christine S Falk, Bethany Foster, Siegfried Geyer, David Gjertson, Mark Greer, Marion Haubitz, Ashley Lau, Britta Maecker-Kolhoff, Nima Memaran, Hans A Messner, Karen Ostendorf, Undine Samuel, Bernhard M W Schmidt, Stefan G Tullius, Lori West, Germaine Wong, Tanja Zimmermann, Marina Berenguer
Organ transplantation as an option to overcome end-stage diseases is common in countries with advanced healthcare systems and is increasingly provided in emerging and developing countries. A review of the literature points to sex- and gender-based inequity in the field with differences reported at each step of the transplant process, including access to a transplantation waiting list, access to transplantation once waitlisted as well as outcome after transplantation. In this review, we summarize the data regarding sex- and gender-based disparity in adult and pediatric kidney, liver, lung, heart and hematopoietic stem-cell transplantation and argue that there are not only biological but also psychological and socio-economic issues that contribute to disparity in the outcome, as well as an inequitable access to transplantation for women and girls...
February 4, 2019: Transplantation
Tomoharu Yoshizumi, Noboru Harada, Masaki Mori
No abstract text is available yet for this article.
February 4, 2019: Transplantation
Nima Memaran, Bianca Borchert-Mörlins, Bernhard M W Schmidt, Rizky I Sugianto, Hannes Wilke, Ricarda Blöte, Ulrich Baumann, Elena Bauer, Anika von Wick, Norman Junge, Christoph Leiskau, Eva D Pfister, Daniela Thurn-Valsassina, Nicolas Richter, Imeke Goldschmidt, Anette Melk
Cardiovascular (CV) events account for 8% to 13% of deaths after liver transplantation (LT) in adulthood. Although CV risk factors are present, little is known about the prevalence of subclinical CV target organ damage in children after LT. The aim of this prospective observational study was to assess the prevalence of subclinical CV target organ damage in children after LT and to identify risk factors contributing to CV damage as potential targets for clinical intervention. In this study, 104 children after LT (54% female, 46% male, aged 11...
February 11, 2019: Liver Transplantation
Tamara Möhring, André Karch, Christine S Falk, Tobias Laue, Lorenzo D'Antiga, Dominique Debray, Loreto Hierro, Deirdre Kelly, Valerie McLin, Patrick McKiernan, Joanna Pawlowska, Piotr Czubkowski, Rafael T Mikolajczyk, Ulrich Baumann, Imeke Goldschmidt
Background: Both, markers of cellular immunity and serum cytokines have been proposed as potential biomarkers for graft rejection after liver transplantation. However, no good prognostic model is available for the prediction of acute cellular rejection. The impact of underlying disease and demographic factors on immune status before pediatric liver transplantation (pLTx) is still poorly understood. We investigated expression of immune markers before pLTx, in order to better understand the pre-transplant immune status...
2019: Frontiers in Immunology
J Briceno, R Ciria, P López, A Luque, A Arjona-Sanchez, J M Sánchez-Hidalgo, M D Ayllón, I Gómez-Luque, J Gomez
Herein we report on laparoscopic donor hepatectomy (left lateral sectionectomy) for pediatric living donor liver transplantation by using a pure laparoscopic approach. Seven laparoscopic living donor procedures were performed during the period March 2016 to February 2017 at our institution. The average age of donors was 33.3 years. Preoperative liver function was normal in all donors. Four donors required 1 or more Pringle maneuver(s). The etiology was biliary atresia (n = 3), metabolic disorders (n = 2) (OTC deficiency), Alagille syndrome (n = 1), and neonatal ductopenia (n = 1)...
January 2019: Transplantation Proceedings
Kai Wang, Zhuo-Lun Song, Bin Wu, Chun-Lei Zhou, Wei Liu, Wei Gao
CD4+ regulatory T cells (Tregs) play an important role in inducing immune tolerance in organ transplantation, which can be divided into CD45RA+ Tregs (resting Tregs, rTregs) and CD45RO+ Tregs (activated Tregs, aTregs). Currently, the expressions and phenotypic changes of Tregs in recipients after liver transplantation (LT) is unknown. We therefore investigated the expression and transformation of rTregs and aTregs in 83 cases of recipients with normal status post-LT. The percentages of CD45RA, CD45RO, CD31 in CD4+ Tregs were detected by flow cytometry and the effective factors were analyzed...
February 5, 2019: International Immunopharmacology
Yukihiro Sanada, Takumi Katano, Yuta Hirata, Naoya Yamada, Noriki Okada, Yoshiyuki Ihara, Koichi Mizuta
BACKGROUND: We present retrospective analysis of our 15-year experience with pediatric living donor liver transplantation (LDLT), focusing on the risk factors, treatments and long-term prognosis for post-transplant biliary complications (BCs). METHODS: Between May 2001 and December 2017, 290 LDLTs were performed. The median age was 1.4 years old. The median observation period was 8.4 years. Biliary strictures were classified as anastomotic stricture (AS) or non-anastomotic stricture (NAS)...
January 30, 2019: Transplantation
Stefanie G Ames, R Scott Watson, Ericka L Fink
No abstract text is available yet for this article.
February 2019: Pediatric Critical Care Medicine
Emily R Perito, Douglas B Mogul, Douglas VanDerwerken, George Mazariegos, John Bucuvalas, Linda Book, Simon Horslen, Heung B Kim, Tamir Miloh, Vicky Ng, Jorge Reyes, Manuel I Rodriguez-Davalos, Pamela L Valentino, Sommer Gentry, Evelyn Hsu
OBJECTIVE: To investigate the impact of prioritizing infants, children, adolescents and the sickest adults (Status 1) for deceased donor livers. We compared outcomes under two "SharePeds" allocation schema, which prioritize children and Status 1 adults for national sharing and enhanced access to (1) pediatric donors or (2) all donors <35 years old, to outcomes under the allocation plan approved by the Organ Procurement and Transplant Network in December 2017 (OPTN 12-2017)...
January 31, 2019: Journal of Pediatric Gastroenterology and Nutrition
Tarek Abdelazeem Sabra, Hideaki Okajima, Atsushi Yoshizawa, Eri Ogawa, Shinya Okamoto, Mohamed Abdelkader Osman, Yasser Saad-Eldin, Shinji Uemoto
We aimed to compare the early results of i.v. with p.o. TAC as a primary immunosuppressant in pediatric patients undergoing LT. This retrospective study enrolled 75 children who underwent LT and received TAC-steroid regimens as a primary immunosuppressant between September 2011 and October 2015 at our institution. Thirty-five recipients received TAC i.v. and 40 received TAC p.o. Early results were evaluated and compared, including ACR, EBV, or CMV infection; renal adverse effects; and hospital stay. Comparisons of 90-day post-transplant results showed that the rates of overall viral (74% vs 40% P < 0...
February 4, 2019: Pediatric Transplantation
Richard J Hendrickson, Joseph Sujka, Ryan Fischer, Michelle Manalang, James Daniel, Walter S Andrews
SRL-based immunosuppressive strategies in pediatric liver transplantation are not clearly defined, especially within the first year after liver transplant. TAC is the more common, traditional immunosuppressant used. However, SRL may modulate TAC-associated kidney injury and may also have antiproliferative properties that are valuable in the management of patients following liver transplantation for HB. We sought to determine whether early conversion from TAC to SRL was safe, effective, and beneficial in a subset of liver transplant recipients with unresectable HB exposed to CDDP-based chemotherapy...
February 4, 2019: Pediatric Transplantation
Frederic Bertino, C Matthew Hawkins, Giri Shivaram, Anne E Gill, Matthew P Lungren, Aaron Reposar, Daniel Y Sze, Gloria L Hwang, Kevin Koo, Eric Monroe
PURPOSE: To examine the technical feasibility and clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in children and adolescents. MATERIALS AND METHODS: Retrospective review was performed of 59 patients (mean age 12.6 y [range, 1.5-20 y], mean weight 47.5 kg [range, 11.4-112.2 kg], mean Model for End-stage Liver Disease/Pediatric End-stage Liver Disease score 12.5 [range, 6-33]) who underwent 61 TIPS attempts at 3 tertiary children's hospitals from 2001 to 2017 for acute esophageal or gastroesophageal variceal bleeding, primary and secondary prevention of variceal bleeding, and refractory ascites...
February 2019: Journal of Vascular and Interventional Radiology: JVIR
Eliah R Shamir, Marsha M Lee, Vighnesh Walavalkar
Leukocyte chemotactic factor 2 amyloidosis (ALECT2) is a recently described form of systemic amyloidosis, which most commonly affects the kidney and liver. The LECT2 protein is produced during inflammatory processes, but its precise function in renal diseases in unclear. ALECT2, however, is known to be a relatively common form of renal amyloidosis, after amyloid light chain and serum amyloid A types and is most often seen in patients of Hispanic ethnicity. ALECT2 can occur de novo or as recurrent disease in kidney transplants...
February 3, 2019: Pediatric Transplantation
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