Pediatric transplantation
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Pediatric transplantation · Dec 2010
ReviewA review of abdominal organ transplantation in cystic fibrosis.
With advances in medical treatments, patients with CF are having improved quality of life and living longer. Although pulmonary disease is still the leading cause of morbidity and mortality, this longevity has allowed for the development of other organ dysfunction, mainly liver and pancreas. ⋯ Deficiency of pancreatic enzymes is almost universal and up to 40% of patients with CF can develop insulin-dependent diabetes, although the role of pancreas transplantation is less clear and needs further research. Finally, the need for lung transplantation should always be assessed and considered in combination with liver transplantation on a case-by-case basis.
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Pediatric transplantation · Nov 2010
Tackling the spectrum of transition: what can be done in pediatric settings?
Transition to adulthood is a complicated process for children with special health care needs. During adolescence, patients must begin to assume responsibility for their medical care as family member's transition health care management from caregivers to patients. At some specific point, patients will also transfer out of pediatrics to adult-oriented services. We present a compilation of manuscripts that describe, study, and offer solutions for these two related challenges as faced by pediatric transplant recipients.
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Pediatric transplantation · Sep 2010
Low donor-to-recipient weight ratio does not negatively impact survival of pediatric heart transplant patients.
A major limitation to success in pediatric heart transplantation is donor organ shortage. While the use of allografts from donors larger than the recipient is accepted, the use of undersized donor grafts is generally discouraged. Using the UNOS database, we wanted to evaluate whether using smaller donor hearts affects the short- and long-term survival of pediatric heart transplant patients. ⋯ Infants with DRWR 0.5-0.59 had lower 30-day survival rate (p = 0.045). There was no difference in short- and long-term survival between the patients with DRWR 0.6-0.79 and DRWR 0.8-2.0. Use of smaller allografts (DRWR 0.6-0.8) has no negative impact on the short- and long-term survival of pediatric heart transplant patients.
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Pediatric transplantation · Sep 2010
Comparative StudyThe efficacy and safety of valganciclovir vs. oral ganciclovir in the prevention of symptomatic CMV infection in children after solid organ transplantation.
Routine prophylaxis for CMV with valganciclovir is common in adult recipients but data to support its use in children are scarce. The aim of this study was to compare the efficacy and safety of valganciclovir vs. ganciclovir in a pediatric cohort. We performed a retrospective analysis of 92 children after KTx and/or LTx. ⋯ No significant side effects were noted in both groups. As in adults, valganciclovir appears to be as efficacious and safe as oral ganciclovir. Valganciclovir should be considered as a possible prophylactic treatment for CMV in pediatric recipients of KTx or LTx.
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Pediatric transplantation · May 2010
Liver transplantation in children with hyper-reduced grafts - a single-center experience.
In small infants and babies who receive split or living-related adult left lateral segmental liver grafts, further reduction (hyper-reduction) of the graft may be necessary to optimize the size of the graft for the child. We report our experience with hyper-reduction of adult left lateral segment grafts in nine children. A retrospective review of the medical records of children who received hyper-reduced grafts at the Children's Hospital at Westmead, Australia was performed. ⋯ Comparable long-term results are possible. The pledgetted technique of resection is easy, quick, and safe. The fact that it can be performed after revascularization with minimal blood loss adds great flexibility to this technically challenging procedure.