Pediatric Transplantation最新文献_第10页

Kidney transplants in small children: Weighing the pros and cons. 儿童肾脏移植:利弊权衡。

IF 1.3 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-17 DOI: 10.1111/petr.14647

Khalid A Alhasan, Sidharth Kumar Sethi, Dieter Clemens Broering

引用次数: 0

Kidney paired donation. 肾脏配对捐赠。

IF 1.3 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-12-06 DOI: 10.1111/petr.14667

Jill R Krissberg, Priya S Verghese

引用次数: 0

Clinical profile of re-hospitalizations in pediatric kidney and liver transplant recipients. 儿童肾和肝移植受者再住院的临床分析。

IF 1.3 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-27 DOI: 10.1111/petr.14658

Adi Shohet, Noa Ziv, Rachel Gavish, Orly Haskin, Hadas Alfandary, Orith Waisbourd-Zinman, Yael Mozer-Glassberg, Irit Krause

{"title":"Clinical profile of re-hospitalizations in pediatric kidney and liver transplant recipients.","authors":"Adi Shohet, Noa Ziv, Rachel Gavish, Orly Haskin, Hadas Alfandary, Orith Waisbourd-Zinman, Yael Mozer-Glassberg, Irit Krause","doi":"10.1111/petr.14658","DOIUrl":"10.1111/petr.14658","url":null,"abstract":"Background: Solid organ transplantation has evolved in recent decades, resulting in a rise in patient and graft survival. Frequent hospitalizations affect graft function, patients' health, and quality of life. This study characterizes the frequency and causes of post-transplant hospitalizations among pediatric recipients.Methods: This is a retrospective observational study evaluating pediatric kidney transplant recipients (KTR) and liver transplant recipients (LTR) aged 0-21 years, followed at a tertiary pediatric center in Israel from 2012 to 2017. Data were collected starting at 60 days post-transplantation. Diagnoses of admissions were based on clinical, laboratory, and radiographic findings.Results: Forty-nine KTR experienced 199 all-cause re-hospitalizations (median number of re-hospitalizations per patient - 3 (IQR [interquartile range] 1-5.5), while 351 re-hospitalizations were recorded in 56 LTR (median - 5 [IQR 2-8.8]). Median follow-up time was 2.2 years for KTR (IQR 1-3.9) and 3 years for LTR (IQR 2.1-4.1). The most common cause for hospitalization for both cohorts was infection (50.8% and 62%, respectively). Gram-negative bacteria were the most common pathogens identified in KTR, while viral pathogens were more common in LTR (51% and 57% of pathogen-identified cases, respectively).Conclusions: This is the largest study to describe rehospitalizations for pediatric solid organ recipients. The hospital admission rate was higher in LTR in comparison to KTR. Infections were the most common cause of hospitalization throughout the whole study period in both populations. Frequent hospitalizations impose a heavy burden on patients and their families; better understanding of hospitalization causes may help to minimize their frequency.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14658"},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes in estimated glomerular filtration rate over the first year following repeat heart transplant in children and young adults. 儿童和年轻人重复心脏移植后第一年肾小球滤过率的变化

IF 1.3 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-27 DOI: 10.1111/petr.14651

Melvin Chan, Lori Silveira, Daniel J Patterson, Margret E Bock, Biagio A Pietra, Melanie D Everitt, Kathleen E Simpson, Shelley D Miyamoto, Scott R Auerbach

{"title":"Changes in estimated glomerular filtration rate over the first year following repeat heart transplant in children and young adults.","authors":"Melvin Chan, Lori Silveira, Daniel J Patterson, Margret E Bock, Biagio A Pietra, Melanie D Everitt, Kathleen E Simpson, Shelley D Miyamoto, Scott R Auerbach","doi":"10.1111/petr.14651","DOIUrl":"10.1111/petr.14651","url":null,"abstract":"Background: Renal function is reduced in patients undergoing heart transplant due to hemodynamic compromise, cardiorenal syndrome, and nephrotoxin exposure. No current studies evaluate renal function in retransplants.Methods: We reviewed all heart transplants at our center from 1995 to 2021 and matched first-time heart transplants with retransplants, based on age at transplant, sex, and race. Estimated glomerular filtration rate (eGFR) was derived from CKiD-U25 calculator using creatinine and measured prior to transplant, 1-week post-transplant, 1-3, 6, and 12 months post-transplant, and recent follow-up. Changes in eGFR were measured within and between patients using a piecewise linear mixed effect model with matching. Exploratory univariate analysis was performed to evaluate pre-transplant risk factors for decreased eGFR.Results: The unmatched cohort included 393 heart transplant recipients, with 47 being retransplants. Thirty-eight patients in both groups with at least 1 year of follow-up underwent matching. Both retransplants and first-time transplants had an initial decline in eGFR. eGFR rebounded to baseline or above baseline at 1-3 months post-transplant, but eGFR in retransplants remained significantly lower. At 1-year post-transplant, the average eGFR was 67.8 ± 4.3 mL/min/1.73 m2 versus 104.7 ± 4.3 mL/min/1.73 m2 (p < .001) in the retransplants and first-time transplants group, respectively.Conclusion: This study provides data on anticipated renal trajectory following retransplantation.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14651"},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138445705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Changes in graft outcomes in recipients <10 kg over 25 years of pediatric kidney transplantation in the United States. 美国小儿肾移植 25 年来体重小于 10 公斤的受者移植结果的变化。

IF 1.2 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-12-27 DOI: 10.1111/petr.14679

Stella Kilduff, Benjamin Steinman, Nicole Hayde

{"title":"Changes in graft outcomes in recipients <10 kg over 25 years of pediatric kidney transplantation in the United States.","authors":"Stella Kilduff, Benjamin Steinman, Nicole Hayde","doi":"10.1111/petr.14679","DOIUrl":"10.1111/petr.14679","url":null,"abstract":"Background: Kidney transplant (KT) was initially associated with poor outcomes, especially in smaller recipients. However, pediatric transplantation has evolved considerably over time. We investigated the impact of weight at the time of transplant and whether outcomes changed over 25 years for <10 kg recipients.Methods: Using the UNOS database, pediatric recipient outcomes were analyzed between 1/1/99 and 12/31/14. KT weight was stratified: <8.6 kg (mean weight of recipients <10 kg), 8.6-9.9 kg, 10-14.9 kg, 15-29.9 kg, and ≥30 kg. Outcomes in recipients <10 kg were then compared between 1990-1999 and 2000-2014.Results: 17 314 pediatric KT recipients were included; 518 (3%) had a transplant weight <10 kg. The highest rates of allograft loss and death were in recipients <8.6 kg and ≥30 kg. Recipients <8.6 kg also had higher rates of delayed graft function, rejection, and longer hospital length of stay. In the multivariable Cox regression model, transplant weight was not a predictor of allograft loss. When compared with recipients <8.6 kg, patient survival hazard ratios associated with recipient weight of 10-14.9 kg, 15-29.9 kg, and ≥30 kg were 0.61 (95%CI: 0.4, 1), 0.42 (95%CI: 0.3, 0.7) and 0.32 (95%CI: 0.2, 0.6), respectively. In the later era of transplant, recipients <10 kg had improved outcomes on univariate analysis; however, the era of transplantation was not an independent predictor of allograft loss or patient survival in Cox regression models.Conclusions: Outcomes in children weighing 8.6-9.9 kg at the time of KT were similar to higher weight groups and improved over time; however, special precautions should be taken for recipients <8.6 kg at the time of transplant.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14679"},"PeriodicalIF":1.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10872313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modern-era successful liver transplantation outcomes in children with hepatic undifferentiated embryonal sarcoma. 当代儿童肝未分化胚胎性肉瘤成功肝移植的结果。

IF 1.2 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-11-27 DOI: 10.1111/petr.14645

Priya S Rolfes, Dor Yoeli, Amy G Feldman, Megan A Adams, Michael E Wachs, Julia M Boster

{"title":"Modern-era successful liver transplantation outcomes in children with hepatic undifferentiated embryonal sarcoma.","authors":"Priya S Rolfes, Dor Yoeli, Amy G Feldman, Megan A Adams, Michael E Wachs, Julia M Boster","doi":"10.1111/petr.14645","DOIUrl":"10.1111/petr.14645","url":null,"abstract":"Background: Hepatic undifferentiated embryonal sarcoma (HUES) is the third most common primary hepatic malignancy in children. If unresectable, liver transplantation (LT) is the only curative option. Historically, HUES LT outcomes were not favorable; however, modern-era data are lacking. We aimed to describe LT outcomes in children with HUES and compared with LT outcomes in children transplanted for hepatoblastoma (HBL) and non-malignancy indications.Methods: Children 18 years or younger with HUES who underwent LT from 1987 to 2021 were identified from the Scientific Registry of Transplant Recipients database. Graft and patient survival were studied in HUES and LT recipients with HBL and non-malignancy indications using Kaplan-Meier analysis. Cox regression was used to compare patient and graft survival among groups, controlling for confounders.Results: Twenty-one children with HUES underwent LT during the study period with a median age at LT of 10 years (IQR: 8-12 years). One and five-year patient survival for HUES recipients was not significantly different from that of recipients with HBL (p = .3) or non-malignancy diagnoses (p = .6). There were no deaths due to HUES recurrence. In multivariable Cox regression, HUES did not increase risk of either patient or graft loss as compared to HBL (HR 2.36, p = .2) or non-malignancy indications (HR 0.74, p = .7).Conclusion: LT outcomes are more favorable in patients with HUES than historically described, and similar to LT outcomes of patients with HBL and non-malignancy indications. Transplant should be considered for HUES patients with unresectable localized tumors.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14645"},"PeriodicalIF":1.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10872980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138445708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

No need for fasting prior to doppler ultrasound of pediatric liver transplants: A self-controlled study. 儿童肝移植多普勒超声检查前无需禁食：一项自我对照研究。

IF 1.2 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-10-10 DOI: 10.1111/petr.14622

Martijn V Verhagen, Hubert P J van der Doef, Thomas C Kwee, Robbert J de Haas

{"title":"No need for fasting prior to doppler ultrasound of pediatric liver transplants: A self-controlled study.","authors":"Martijn V Verhagen, Hubert P J van der Doef, Thomas C Kwee, Robbert J de Haas","doi":"10.1111/petr.14622","DOIUrl":"10.1111/petr.14622","url":null,"abstract":"Background: Children frequently undergo routine Doppler-ultrasound (DUS) after liver transplantation (LT) for which they are fasted, but this may cause hunger and discomfort.Objective: To determine if DUS measurements, with focus on the portal vein (PV), are affected by prandial changes, and if this affects distress and feasibility of the DUS.Materials and methods: Children were prospectively included to undergo a pre- and postprandial DUS on the same day at 6 months after LT. Pre- and anastomotic PV peak systolic velocity (PSV), and hepatic artery and hepatic vein DUS measurements were obtained. Pre- and postprandial measurements, and relative postprandial change of PV velocity ratio (VR) compared to PV anastomotic PSV, were compared using paired-sample t-tests and intraclass correlation coefficients (ICC). Obscuration by bowel gas, difficulty of DUS, and impact of fasting were assessed using 5-point rating scales.Results: Twenty-eight children (median age 3.5 years, IQR 1.6-10.8) were included; four were subsequently excluded because they were not fasted (N = 2) or withdrew consent for the second DUS (N = 2). Measurements between pre- and postprandial DUS, and relative postprandial change of VR compared to PV anastomotic PSV, were not significantly different (p > .05). Test consistency was good (ICC = 0.69, 95% CI = 0.29-0.67) for PV anastomotic PSV, and excellent (95% CI = 0.61-0.93) for PV VR. Obscuration by bowel gas or ease of DUS did not change after eating (p > .05). The majority (16/28, 57.2%) found fasting difficult, and several (13/28, 46.4%) got upset when fasted.Conclusion: Children with an LT do not need to be fasted for routine DUS, which may decrease the burden of the examination.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14622"},"PeriodicalIF":1.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41183326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of apixaban in children awaiting heart transplantation. 阿哌沙班在等待心脏移植的儿童中的应用。

IF 1.2 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-10-28 DOI: 10.1111/petr.14632

Victor Benvenuto, Christina Hartje-Dunn, Linda Vo, Amy Hellinger, Paul Esteso, Francis Fynn-Thompson, Christina VanderPluym

{"title":"Use of apixaban in children awaiting heart transplantation.","authors":"Victor Benvenuto, Christina Hartje-Dunn, Linda Vo, Amy Hellinger, Paul Esteso, Francis Fynn-Thompson, Christina VanderPluym","doi":"10.1111/petr.14632","DOIUrl":"10.1111/petr.14632","url":null,"abstract":"Background: The use of apixaban in the pediatric cardiac population is expanding. We describe our apixaban dosing and monitoring strategy in children and young adults awaiting heart transplantation, along with outcomes related to bleeding and thrombosis during wait-list and early post-transplant periods.Methods: This study is a retrospective, single-center analysis of all patients receiving apixaban while awaiting cardiac transplantation. Weight-based dosing was monitored with peak drug-specific anti-Xa chromogenic analysis. Significant post-operative bleeding defined by chest tube output or need for surgical intervention.Results: From September 2020 to December 2022, 19 patients, median age 13.5 years (6.1, 15.8 years), weighing 48.9 kg (15.4, 67.6) received apixaban while awaiting transplant. Indication for apixaban was prophylaxis (n = 18, 3 with ventricular assist devices) and treatment of thrombus (n = 1). There were no clinically relevant non-major or major bleeding, nor thrombotic events while awaiting transplant. The median time from last apixaban dose to arrival in the operating room was 23.2 h (15.6-33.8), with median random apixaban level of 37 ng/mL (28.3, 59), 6.3 h (4.8, 8.4) prior to arrival in the operating room. In this study, 32% of patients had significant post-operative bleeding based on chest tube output post-transplant or need for intervention. No patients meeting criteria for significant post-operative bleeding were thought to be attributable to apixaban.Conclusions: Careful use of apixaban can be safe and effective while awaiting heart transplant. There was no appreciable increase in peri-operative bleeding. The use of apixaban is promising in providing safe, predictable and efficacious anticoagulation while avoiding additional patient stressors.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14632"},"PeriodicalIF":1.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61564693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

International pediatric transplant association (IPTA) guidance on developing and/or expanding pediatric solid organ transplantation programs in low- and middle-income countries. 国际儿科移植协会（IPTA）关于在中低收入国家发展和/或扩大儿科实体器官移植计划的指南。

IF 1.2 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2022-12-05 DOI: 10.1111/petr.14346

Hanh D Vo, Fiona Mackie, Mignon McCulloch, Raymond Reding

引用次数: 0

Liver transplantation in patient with Berardinelli-Seip syndrome: A literature review and case report. Berardinelli-Seip 综合征患者的肝移植：文献回顾与病例报告。

IF 1.3 4区医学

Pediatric Transplantation Pub Date : 2024-02-01 Epub Date: 2023-12-27 DOI: 10.1111/petr.14680

Altay Aliyev, Elgun Samadov, Arturan Ibrahimli, Akbar Hajiyev, Gunay Allahverdiyeva, Eldar Ahmadov

{"title":"Liver transplantation in patient with Berardinelli-Seip syndrome: A literature review and case report.","authors":"Altay Aliyev, Elgun Samadov, Arturan Ibrahimli, Akbar Hajiyev, Gunay Allahverdiyeva, Eldar Ahmadov","doi":"10.1111/petr.14680","DOIUrl":"10.1111/petr.14680","url":null,"abstract":"Background: Berardinelli-Seip syndrome is an infrequently seen and potentially fatal genetic disorder characterized by the absence of adipose tissue. Herein, we report a first-in-literature liver transplant done on a 7-year-old girl because of liver cirrhosis caused by the Berardinelli-Seip syndrome.Case report: Physical examination showed prominent subdermal fat tissue loss and mild muscle hypertrophy, giving her a slim appearance, hirsutism, thick hair, a large head in contrast to the body, low anterior hairline, icterus, prominent facial contours, prominent mandibula, loss of buccal fat, low set ears, and large limbs. After the diagnosis, she admitted to our clinic because of variceal esophageal bleeding and increasing liver enzymes. Transplantation decision was made and orthothopic liver transplantation done by the surgery team.Discussion: Common causes of death in Berardinelli-Seip syndrome patients are infections and liver cirrhosis. The mean age of the patients was 27.1 at the time of death. There is no any established cure for congenital lipodystrophies so far. However, some symptomatic treatment methods are found to be helpful. The main point of the case report to be discussed is the liver transplantation done by our surgical team. There are no examples of any transplantation in Berardinelli-Seip syndrome patients, but several reports can be found of patients with kidney or liver failure.Conclusion: Berardinelli-Seip syndrome is a rare disorder with no cure but a chance of improving lifestyle and life expectancy. The transplantation option should be considered in young patients after a multidisciplinary review.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":" ","pages":"e14680"},"PeriodicalIF":1.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0