Abstract:
:Post-transplantation biliary strictures occur in 5-15% of the pediatric liver transplant patients and are conventionally managed by interventional radiological techniques. Failure of this treatment leads to reoperation and sometimes to retransplantation. Herein, we describe a surgical approach and interventional radiologic approach to manage biliary strictures that failed the conventional radiologic treatment, in order to avoid retransplantation. Included in the study were eight children who underwent liver transplantation at our center or referred to our institution for evaluation of the biliary strictures that failed radiological treatment. Biliary strictures were confirmed by a narrowing of the biliary anastomosis on the percutaneous transhepatic cholangiogram. At surgery, a guide wire was introduced into the distal bile system through the use of an enterotomy in Roux limb. Over the guide wire, the stricture was ballooned and the diameter of the biliary tree was determined. A pigtail catheter was introduced on the biliary tree across the abdominal wall, the liver, the stricture and the anastomosis into the enterotomy. A final cholangiogram confirmed the positioning of the catheter. Mean follow-up was 39.8 +/- 20.8 months. All patients had their strictures successfully treated and survived the procedure. Three patients were readmitted to the hospital with fever. It was necessary to revise the hepaticojejunostomy in three patients because of cholangitis and/or recurrence of biliary stricture. Of the eight patients of this study, two required retransplantation and one died. We conclude that an aggressive combined surgical and radiologic approach can avoid retransplantation in patients with complicated post-transplant biliary strictures.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Salvalaggio PR,Bambini DA,Donaldson J,Saker M,Whitington PF,Alonso EM,Superina RAdoi
10.1111/j.1399-3046.2004.00212.xkeywords:
subject
Has Abstractpub_date
2004-10-01 00:00:00pages
513-6issue
5eissn
1397-3142issn
1399-3046pii
PTR212journal_volume
8pub_type
杂志文章abstract::Many pediatric centers utilize a variety of protocols including preemptive plasmapheresis to prevent the recurrence of FSGS post-transplant. But the effectiveness of this expensive, time-consuming process of plasmapheresis in the prevention of FSGS recurrence is still unclear. We retrospectively reviewed all pediatric...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13154
更新日期:2018-05-01 00:00:00
abstract::Antibody-mediated rejection (AMR) has recently been recognized as a significant and unique form of rejection that is not amenable to treatment with standard immunosuppressive medications aimed at modification of T-cell function. Recent interest in AMR and the role of B cells in rejection has been aided by the concomit...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-3046.2005.00363.x
更新日期:2005-06-01 00:00:00
abstract:UNLABELLED:Liver transplantation treats the hepatic affectation of UCDs; however, irreversible neurologic damage pretransplant is difficult to assess providing transplant teams with ethical dilemmas for liver transplantation. The purpose of our study was to determine whether pretransplant neuroimaging can predict devel...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12520
更新日期:2015-08-01 00:00:00
abstract::This 18-month prospective investigation sought to examine changes in HRQOL over time for adolescent solid organ transplant recipients. Additionally, this study examined the relationship between adolescent and parent report of HRQOL and compared parent report of HRQOL to published normative data. Forty-eight adolescent...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2010.01392.x
更新日期:2010-12-01 00:00:00
abstract::Mortality is the highest of any solid organ in pediatric patients awaiting heart transplantation. Strategies to increase the donor pool are needed if survival to transplant is to improve. There can be reluctance to accept pediatric hearts for transplantation if the donor has received cardiopulmonary resuscitation (CPR...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2011.01565.x
更新日期:2011-11-01 00:00:00
abstract::This single-centre, retrospective, observational pilot study was performed to evaluate the safety and efficacy of intravenous and oral itraconazole prophylaxis in paediatric haematopoietic stem cell transplantation (HCT). Study end-points were proven invasive fungal infection (IFI), survival, adverse reactions and gra...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2006.00643.x
更新日期:2007-05-01 00:00:00
abstract::Myocarditis represents an important cause for acute heart failure. MYKKE, a prospective multicenter registry of pediatric patients with myocarditis, aims to gain knowledge on courses, diagnostics, and therapy of pediatric myocarditis. The role of mechanical circulatory support (MCS) in children with severe heart failu...
journal_title:Pediatric transplantation
pub_type: 杂志文章,多中心研究
doi:10.1111/petr.13548
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Pediatric heart-lung transplantation (HLT) is rare, and no report has analyzed patient outcomes since time of listing. We analyzed pediatric HLTs to understand risk factors for waitlist and post-HLT mortality. METHODS:All pediatric (<18 year old) HLT candidates were identified within the UNOS database (n = ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13682
更新日期:2020-05-01 00:00:00
abstract::This review details the indications for heart transplantation in children. Contraindications have evolved from absolute to relative. Controversial issues remain and this paper represents a consensus of more than a dozen centers that have programs that remain active performing pediatric heart transplants. ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-3046.1999.00045.x
更新日期:1999-11-01 00:00:00
abstract::Maintaining fluid balance, pre- and post-MA-HCT is essential and usually requires frequent administration of diuretics. Hepatic sinusoidal obstructive syndrome is potentially life-threatening, especially when associated with AKI and MOF. This study describes six patients who developed AKI-associated SOS and diuretic-r...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13139
更新日期:2018-03-01 00:00:00
abstract::Cystic fibrosis (CF) is associated with varying degrees of pleural inflammatory reaction that occurs as a result of chronic pulmonary infections and intervention to pleural space. The amount of pleural reaction is associated with the difficulty involved when performing the pneumonectomy at the time of lung replacement...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::The aim of this study was to study the incidence of chronic renal dysfunction in patients with more than 5 yr of follow-up following liver transplantation and to evaluate the benefit of decreasing cyclosporine A (CsA) dose combined with mycophenolate mofetil (MMF) on renal function and immune response in these patient...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2004.00172.x
更新日期:2004-10-01 00:00:00
abstract::eHAT is one of the most dreaded post-LT complication. Treatment approaches include retransplantation, revascularization, or observation. Systemic thrombolytic therapy is used in pediatric patients with thromboembolic events. However, there is no previous study reporting on the use of systemic r-tPA to treat eHAT. The ...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13902
更新日期:2020-10-27 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::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::Castleman disease is a rare hematologic disorder, closely linked to the HHV-8, and most commonly observed in immunocompromised individuals. Thirteen months following a liver transplant for CPS-1 defect, a 15-month-old boy presented with fevers, anemia, and growth retardation. Abdominal CT scan showed splenomegaly and ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-3046.2011.01570.x
更新日期:2012-09-01 00:00:00
abstract::This retrospective case series reviews our center's experience with sirolimus and a CNI as alternative therapy for the treatment of PTAH. It also characterizes regulatory T cells (Tregs) in PTAH. LT recipients with PTAH who had received or were receiving treatment with sirolimus were retrospectively identified (n = 12...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2012.01648.x
更新日期:2012-03-01 00:00:00
abstract::There are limited published data on surveillance TBB for the identification of allograft rejection in infants after lung or heart-lung transplantation. We performed a retrospective review of children under one yr of age who underwent lung or heart-lung transplant at our institution. Since 2005, four infants were trans...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12125
更新日期:2013-11-01 00:00:00
abstract::The need for evidence-based practice guidelines requires high quality, carefully controlled clinical research trials. This multidisciplinary conference attempted to: identify urgent clinical and research issues, identify obstacles to performing clinical trials, develop concepts for organ-specific and all-organ researc...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00811.x
更新日期:2008-03-01 00:00:00
abstract::The examination of predictors of non-adherence in transplantation populations offers the potential to identify high-risk individuals and concomitantly generate effective adherence-promoting interventions. The present paper aggregated quantitative estimates of various correlates of treatment adherence in studies of ped...
journal_title:Pediatric transplantation
pub_type: 杂志文章,meta分析
doi:10.1111/j.1399-3046.2007.00864.x
更新日期:2008-09-01 00:00:00
abstract::Liver and small bowel transplant is an established treatment for infants with IFALD. Despite organ reduction techniques, mortality on the waiting list remains high due to shortage of size-matched pediatric donors. Small abdominal cavity volume due to previous intestinal resection poses a significant challenge to achie...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12138
更新日期:2013-11-01 00:00:00
abstract::Little has been studied regarding the diets of children following LTX. The study aim was to assess and compare dietary intake and DQ of healthy children and children post-LTX. Children and adolescents (2-18 years) post-LTX (n=27) and healthy children (n=28) were studied. Anthropometric and demographic data and two 24-...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12944
更新日期:2017-09-01 00:00:00
abstract::Renal transplantation is the therapy of choice in children with ESKD. Radiological investigations are required in both pre- and post-transplant assessment, although there is paucity of both consensus-based statements and evidence-based imaging guidelines in pediatric renal transplantation. The phases of pediatric ESKD...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/petr.12885
更新日期:2017-05-01 00:00:00
abstract::PMF of infancy is a recently described autosomal recessive disorder presenting with severe bone marrow failure, accelerated neutrophil apoptosis, and significant platelet dysfunction, caused by a mutation in the VPS45 gene. In this study, we update our group of patients with PMF, highlighting different aspects of this...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12169
更新日期:2013-12-01 00:00:00
abstract::Impact of pretransplant splenectomy in patients with beta-thalassemia major undergoing an allogeneic SCT has never been addressed. Twenty-seven class III patients (29 transplants) had a pretransplant splenectomy. The outcome of these 29 transplants was compared with 76 transplants in class III who did not have a splen...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2008.00953.x
更新日期:2009-03-01 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::Treatment of severe aplastic anemia (SAA) patients who lack human leukocyte antigen (HLA)-matched donors and failed immunosuppressive therapy (IST) is challenging. Recently, umbilical cord blood transplantation (CBT) after non-myeloablative therapy has been reported in adult but not in childhood SAA. However, most cas...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2006.00486.x
更新日期:2006-06-01 00:00:00
abstract::Neoplasms in children after organ transplantation are related to the type and intensity of immunosuppression and the donor-recipient serostatus, especially in relation to the Epstein-Barr virus. The patient was a two-yr-old female child with biliary atresia who underwent a liver transplantation from a female cadaver d...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-3046.2012.01711.x
更新日期:2012-12-01 00:00:00
abstract::Predictors of successful transition from pediatric to adult services include ability to self-manage and engage with healthcare services. Parents have a key role in healthcare management throughout childhood and adolescence including encouraging development of self-management skills in their children. Transition to adu...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12760
更新日期:2017-02-01 00:00:00
abstract::Despite significant interest by pediatric transplant patients in meeting others who have undergone transplantation, geographic distances combined with their daily routines make this difficult. This mixed-method study describes the use of Zora, a Web-based virtual community designed to create a support system for these...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2010.01271.x
更新日期:2010-03-01 00:00:00