Abstract:
:It is the practice of many pediatric renal transplant programs to 'convert' children taking cyclosporin A (CsA) to tacrolimus, although the indications for, outcome, and complications of this practice remain obscure. To better understand these aspects of tacrolimus 'conversion', a fax survey was sent to 119 North American pediatric renal transplant centers. Analyzable responses were received from 52 centers (44%), and included data from approximately 1,815 pediatric renal transplants performed between 1991 and 98. Strong indications for tacrolimus conversion were: antibody-resistant rejection, CsA-resistant rejection, and CsA intolerance (strong indication in 72%, 65%, and 52% of centers, respectively). Steroid-resistant rejection and cosmetic side-effects were considered strong indications less often. Initial anti-rejection therapy was usually increased corticosteroid dose (47/52 centers). Antibody therapy was most commonly used for steroid-resistant rejection (44 centers). For steroid- and antibody-resistant rejection, tacrolimus conversion was most common (33 centers). Tacrolimus conversion for antibody-resistant rejection led to improvement of serum creatinine (SCr) in 27% of patients, stabilization of SCr in 46%, worsening of SCr in 11%, and graft loss in 16%. Reported complications after tacrolimus conversion included hyperglycemia, hyperkalemia, lymphoproliferative disorder, infection, and neurologic problems. We conclude that the major indication for tacrolimus conversion in pediatric transplant programs appears to be rejection. Outcome after tacrolimus conversion appears good, with the majority of patients experiencing stable or improved allograft function. These data provide direction for further study, including timing of tacrolimus conversion and interaction with other therapies.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Flynn JT,Bunchman TE,Sherbotie JRkeywords:
subject
Has Abstractpub_date
2001-12-01 00:00:00pages
439-46issue
6eissn
1397-3142issn
1399-3046pii
042journal_volume
5pub_type
杂志文章abstract:INTRODUCTION:Myeloablative conditioning before allogeneic HSCT during childhood exposes to serious long-term complications, especially gonadal dysfunction. Pubertal issues are less described than other post-HSCT sequelae in childhood. METHODS:Pubertal development and biological gonadal parameters were assessed in a re...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13773
更新日期:2020-09-01 00:00:00
abstract::Cardiac transplantation for children with end-stage cardiac disease with no other medical or surgical options is now standard. The number of children in need of cardiac transplant continues to exceed the number of donors considered "acceptable." Therefore, there is an urgent need to understand which recipients are in ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.13671
更新日期:2020-05-01 00:00:00
abstract::We report a case of arterio-portal fistulae in a 12-month-old-child following a segmental liver transplantation. The fistula, probably the result of mass ligature of a vascular pedicle during back table allograft reduction, is to our knowledge the first such case reported. Diagnosed on the third post-operative day, th...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-3046.2002.t01-2-00002.x
更新日期:2002-10-01 00:00:00
abstract::With the number of long-term HSCT survivors steadily increasing, attention needs to be focused on the late complications and quality of life. We therefore analyzed the outcome of 101 pediatric patients (<18 years old at the time of HSCT) transplanted for acute leukemia between 1981 and 2015 at Complexo Hospital de Clí...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13691
更新日期:2020-06-01 00:00:00
abstract::This study analyzes the data reported to the Korean Cord Blood Registry between 1994 and 2008, involving children and adolescents with non-malignant diseases. Sixty-five patients were evaluated in this study: SAA (n = 24), iBMFS, (n = 16), and primary immune deficiency/inherited metabolic disorder (n = 25). The CI of ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12213
更新日期:2014-03-01 00:00:00
abstract::UCBT recipients with TM are at high risk of EF related to low number of stem cells and prior alloimmunization after multiple blood transfusions. Here, we evaluated the safety and efficacy of double-unit UCBT using TT-containing conditioning regimens in TM. Retrospective analysis of children who underwent double-unit U...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13901
更新日期:2020-11-02 00:00:00
abstract::The thymus gland possesses the ability to regrow in children leading to a newly developed anterior mediastinal mass. This condition may represent a rebound phenomenon during recovery from a stressful event such as post-chemotherapy and hence was described as RTH. RTH after LT has not been well documented. We are repor...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13251
更新日期:2018-07-24 00:00:00
abstract::CHS is a rare immunodeficiency syndrome with defects in the functions of cytotoxic cells and neutrophils. Approximately 85% of patients with CHS undergo an AP within the first decade, which is similar to FHLH. Chemotherapy could induce transient remission, but only allogeneic HCT could correct the underlying genetic d...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13014
更新日期:2017-11-01 00:00:00
abstract::Data from 997 pediatric LT recipients were used to model demographic and medical variables as predictors of lower levels of HRQOL. Data were collected through SPLIT FOG project. Patients were between 2 and 18 yr of age and survived LT by at least 12 months. Parents and children (age ≥ 8 yr) completed PedsQL™ 4.0 Gener...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12126
更新日期:2013-11-01 00:00:00
abstract::Clinical grading of GI involvement during acute GVHD remains a challenging issue, especially in children. Plasma citrulline, a non-protein amino acid selectively produced and released by enterocytes, is a suitable surrogate endpoint for small intestinal epithelial cell mass, irrespective of the underlying cause of cel...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12128
更新日期:2013-11-01 00:00:00
abstract::EBV is associated with various malignancies in patients with acquired or induced immune impairment. EBV-SMT is very uncommon in immunocompromised patients, and a kidney localization has been described only anecdotally. We report the case of a 17-yr-old kidney transplant recipient diagnosed as having an EBV-SMT inside ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2009.01213.x
更新日期:2010-12-01 00:00:00
abstract::Adolescence is a difficult time for transplant recipients, who need to cope with the challenges of becoming independent from their parents, as well as taking responsibility for their own behavior and medication. They need to balance their developing sexuality with a body image which may be affected by the side-effects...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-3046.2002.01090.x
更新日期:2002-12-01 00:00:00
abstract::Immunosuppression regimens after liver transplantation focus mainly on preventing rejection and subsequent graft loss. However, in children, morbidity and mortality rates from infections exceed those from rejection after transplant, and immunosuppression can hinder growth, renal function, and graft tolerance. We hypot...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2008.01061.x
更新日期:2009-08-01 00:00:00
abstract::With small kidneys, EBKTs could provide sufficient renal mass but could lead to inefficient use of resources, while SKTs could result in insufficient function due to small renal mass. We aimed to compare the outcomes of EBKT and SKT from small donors weighing ≤15 kg to pediatric recipients. We retrospectively reviewed...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13719
更新日期:2020-05-06 00:00:00
abstract::Administration of hematopoietic growth factors, with or without chemotherapy, can augment progenitor cell numbers available for collection. The dose of granulocyte colony stimulating factor (G-CSF) used for mobilization of peripheral blood progenitor cells (PBPC) is controversial, and doses between 5 and 32 microg/kg/...
journal_title:Pediatric transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-05-01 00:00:00
abstract::Biliary atresia is defined as partial or total obliteration of the extra-hepatic bile ducts. In advanced cases, liver transplantation (LTx) is considered the most appropriate treatment. This report describes a female patient whose biliary atresia and subsequent cirrhosis required LTx at 1 yr of age. Macroscopic inspec...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-3046.2001.t01-1-00020.x
更新日期:2001-02-01 00:00:00
abstract::Intestinal transplant recipients are at risk of micronutrient deficiency due to the slow process of post-transplant adaptation. Another contributing factor is calcineurin inhibitor-induced renal tubular dysfunction. Patients are typically supplemented with micronutrients during PN; however, the risk of deficiency may ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12132
更新日期:2013-11-01 00:00:00
abstract::Graft-versus-host disease (GVHD) is related to considerable morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Cardiac complications associated with GVHD are uncommon, and coronary artery involvement is even more unusual. We report on a male pediatric patient with chronic GVHD who...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13474
更新日期:2019-08-01 00:00:00
abstract::Liver transplant is a treatment option for patients with MMA-emia. While this therapy does not bring about a complete cure, it is expected to prolong survival and improve the QOL of patients. The aim of this study was to evaluate the significance of LDLT for patients with MMA-emia in Japan. Clinical information on 13 ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12804
更新日期:2016-12-01 00:00:00
abstract::OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12440
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:The objective of the study was to analyze the profile of infections in children with BMF following alloHCT. METHODS:Data of 169 consecutive children with inherited and acquired BMF treated with alloHCT between 2012 and 2017 in Polish pediatric transplant departments were analyzed in registry-based retrospec...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13592
更新日期:2019-12-01 00:00:00
abstract::The indications for and the timing of LT and/or KT for the patients with HRFCD are based on the severity of liver and kidney involvement. Most organs come from living donors, because the number of deceased donors is extremely low in Japan. Therefore, patients with HRFCD may need two organs from living donors. Four pat...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2011.01609.x
更新日期:2012-02-01 00:00:00
abstract::Organ transplant is life-saving and any given organ may be valuable to a multitude of potential recipients. An allocation system must be used to reconcile the difference between supply and demand, and this system must take into account the impact that accepting international patients may have on the local system. The ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.12769
更新日期:2016-09-01 00:00:00
abstract::PV thrombosis following pediatric LT is a serious complication that may lead to graft loss. LDLT poses limitations with regard to the availability of vein grafts for complex PV reconstructions. We herein report a unique reconstruction of the PV inflow in a one-yr-old boy with situs inversus undergoing re-LDLT. The inf...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.12703
更新日期:2016-06-01 00:00:00
abstract::Early graft loss and poor graft function limit the use of kidneys from infant donors. Six en bloc kidney transplantations were performed from infant donors younger than 10 months into pediatric recipients between November 2012 and September 2015 at our center. We retrospectively analyzed recipient and donor demographi...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12845
更新日期:2017-03-01 00:00:00
abstract::HCV infection is the leading cause of liver transplantation in the adult population in the United States. HCV infection occurs in 0.2-0.4% of the pediatric population and progression to HCC is uncommon. Liver transplantation for HCV in children is rare. In this report, we present a case of pediatric patient with HCV a...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12223
更新日期:2014-03-01 00:00:00
abstract::DTI indices have been associated with cellular rejection in adult heart transplant recipients, but their predictive value in pediatric recipients is unknown. The purpose of this study was to evaluate DTI measures in the detection of cellular and AMR in pediatric heart transplant recipients. One hundred and forty-eight...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00812.x
更新日期:2008-03-01 00:00:00
abstract::To analyze the clinical profile and outcome of pediatric patients who had undergone a liver and/or RT at our center over a five yr period, case records of all the patients who had undergone a liver or RT were analyzed retrospectively. One hundred solid organ transplants were performed at our center between January 200...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12324
更新日期:2014-11-01 00:00:00
abstract::Live viral vaccines have historically been avoided in children after solid organ transplantation. Multiple reports of safety and immunogenicity, largely in the pediatric liver transplant population, have led to a reconsideration of this recommendation. Here, we report the case of a 4-year-old boy who inadvertently rec...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13667
更新日期:2020-06-01 00:00:00
abstract::Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13009
更新日期:2017-09-01 00:00:00