Abstract:
:De novo PTAID may develop in pediatric solid organ transplant recipients, have a diverse spectrum, and are occasionally treatment resistant. Previous reports showed resolution of immune cytopenias in solid organ transplant recipients following replacement of the calcineurin inhibitor tacrolimus with the mTOR inhibitor sirolimus. Herein we describe a retrospective review (2000-2017) of subjects who developed PTAID in whom immunosuppression was changed to sirolimus. Eight recipients (6 males) of either liver (n = 7) or multivisceral transplant (n = 1) suffered from severe, treatment-resistant PTAID and were switched from tacrolimus to sirolimus. The median age at transplant was 1 year (range 0.5-2.4 years). Six (75%) recipients developed de novo allergy and 2 immune-mediated diseases. The median age at presentation of PTAID was 2.7 (1.4-9) years at a median of 1.3 (0.25-8) years after transplantation. The median time from PTAID presentation to conversion to sirolimus was 1.8 (0.45-10) years. Complete resolution of symptoms was seen in 4 (50%) patients after a median of 12 (range 4-24) months including 2 patients with immune-mediated disease, 1 eczema, and 1 with eosinophilic colitis. One patient with multiple food allergies had a partial response and 3 (38%) had no response. None of the 8 recipients developed sirolimus-attributed adverse events or acute rejection during a median follow-up of 5 (0.6-8) years after the conversion. Immunosuppression conversion from tacrolimus to sirolimus can be an effective therapy in patients suffering severe or treatment-resistant PTAID, suggesting a potential role for tacrolimus in the pathogenesis of PTAID.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Kehar M,Grunebaum E,Jimenez-Rivera C,Mozer-Glassberg Y,Jamal A,Ng VL,Avitzur Ydoi
10.1111/petr.13737subject
Has Abstractpub_date
2020-09-01 00:00:00pages
e13737issue
6eissn
1397-3142issn
1399-3046journal_volume
24pub_type
杂志文章abstract::Small bowel transplantation has become a life-saving procedure for selected adults and children with intestinal failure who are intolerant to parental nutrition. There are few pediatric data available on the results of this procedure. In this article we review the background of intestinal transplantation, present the ...
journal_title:Pediatric transplantation
pub_type: 杂志文章,多中心研究
doi:
更新日期:1997-11-01 00:00:00
abstract::This study aims to evaluate BMD and bone biomarkers and to investigate the effects of immunosuppressives on bone disease after RTx. Thirty-three RTR aged 16.7 ± 3.7 yr and healthy controls (n = 32) were enrolled. There was no difference between pre-RTx BMD and BMD at the time of study (45.9 ± 30.9 months after RTx), w...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12469
更新日期:2015-06-01 00:00:00
abstract::Pneumatosis intestinalis is an uncommon finding beyond the neonatal period, but it has been reported in immunocompromized pediatric patients. The association of pneumatosis intestinalis in children following renal transplantation has to the best of our knowledge been only reported once in children. We describe a 4-yea...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-3046.2003.00061.x
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Of the 600 pediatric candidates added to the liver waiting list annually, 100 will remain waiting while over 100 liver allografts are discarded, often for subjective reasons. METHODS:We created a risk index to predict discard to better optimize donor supply. We used the UNOS database to retrospectively anal...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13963
更新日期:2021-01-06 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
abstract:BACKGROUND:The optimal conditioning regimen for alloHCT in children with myeloid malignancies remains undefined. PROCEDURE:We performed a retrospective review of children undergoing alloHCT for AML and MDS over a 10-year period (2008-2018) at our institution, comparing the outcomes of recipients of either a myeloablat...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13672
更新日期:2020-06-01 00:00:00
abstract::aHUS is caused by the over-activation and dysregulation of the alternative complement pathway. Data regarding outcomes of pediatric aHUS patients after kidney transplantation are still very scarce. Accordingly, the aim of this study was to describe the clinical findings and outcomes of pediatric aHUS patients after re...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13914
更新日期:2020-11-20 00:00:00
abstract::Acute liver failure (ALF) is a rare but often fatal disorder in childhood. Its aetiology includes infections, toxins, metabolic disorders, infiltrative diseases, autoimmune hepatitis, ischaemia, irradiation damage, but in a high proportion of cases it remains unknown. In contrast to adults, in children with ALF hepati...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2004.00292.x
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:ILNEB constitute an autosomal recessive disorder caused by homozygous or compound heterozygous mutation of the gene for the ITGA3. To date, 8 ILNEB patients have been reported, but all 6 neonatal-onset ILNEB patients suffered early death within 2 years. The most common cause of death among previously reporte...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13971
更新日期:2021-01-20 00:00:00
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 Amer...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract:UNLABELLED:The Latin American Pediatric Nephrology Association (ALANEPE) reports the first regional kidney transplant registry in Latin America. A mean range of 75%, 30% to 100% renal transplant recipients under 21 yr old were included. Out of 20 countries invited to participate, 14 performed renal transplant, 11 had u...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2010.01331.x
更新日期:2010-09-01 00:00:00
abstract::We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the per...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2009.01179.x
更新日期:2011-05-01 00:00:00
abstract::T1D is an autoimmune disease, which may be caused by lack of insulin-secreting β cells due to damage of autoimmune system. Living with T1D is a challenge for the child and the family; cell transplantation is a treatment option for diabetes in children. To establish a microenvironment suitable for cell growth and proli...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12443
更新日期:2015-06-01 00:00:00
abstract::The safe observation time following pediatric renal transplant biopsy is unknown. To predict the safety of day-care pediatric renal transplant biopsy, we retrospectively evaluated the timing, incidence and severity of post-biopsy complications in children observed overnight. Biopsies were performed under real time ult...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2005.00433.x
更新日期:2006-03-01 00:00:00
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 radio...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2004.00212.x
更新日期:2004-10-01 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::Rabbit antithymocyte globulin (ATG-F) is an extensively used induction agent. To our knowledge, no study to date has assessed reduced ATG-F dosage in children undergoing renal transplantation. This was a retrospective analysis of pediatric renal recipients in the Department of Kidney Transplantation, The First Affilia...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12224
更新日期:2014-05-01 00:00:00
abstract::Secondary failure of platelet engraftment occurs in 20% of patients undergoing allogeneic HSCT and is associated with poor outcome. Currently, there are no guidelines for treatment of late thrombocytopenia and platelet transfusion is the mainstay of treatment. Here, we describe the use of Eltrombopag to treat secondar...
journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13017
更新日期:2017-09-01 00:00:00
abstract::Studies are increasingly recognizing health-related quality of life (HRQOL) as a key pediatric outcome in both clinical and research settings and an essential health outcome measure to assess the effectiveness of medical treatment. However, it has not yet been studied among the healthy siblings of kidney transplant re...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13734
更新日期:2020-08-01 00:00:00
abstract::The relationship between SES and outcomes surrounding pediatric cardiac transplantation is complex and influenced by recipient race. Broad-based studies of SES have not been performed. A retrospective review of all 5125 primary pediatric heart transplants performed in the United States between 2000 and 2011. Patients ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12117
更新日期:2013-09-01 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::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::Pharmacokinetic studies in adult and pediatric liver transplant recipients have shown that the C(2) monitoring is superior to the traditional determination of CsA trough levels (C(0)) as an estimate of CsA exposure. However, target reference values for C(2) in very small infants have not been established yet. The obje...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1046/j.1399-3046.2003.00138.x
更新日期:2004-04-01 00:00:00
abstract:UNLABELLED:OLT is a life-saving option for ALF. AIM:To evaluate our outcomes in pediatric OLT for ALF. METHODS:Retrospective review of our data between 1992 and 2007. RESULTS:Of 142 children with ALF, 126 were listed, of which 40 spontaneously improved, nine died, and 77 underwent OLT (median waiting time four days)...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2010.01356.x
更新日期:2010-11-01 00:00:00
abstract::An increased frequency of infections has been reported in patients with chronic liver disease. The tendency of patients in this population to acquire UTI is not completely understood. We aimed at investigating the incidence of UTI in children with cirrhosis, before liver transplantation. Twenty-six children (9 girls, ...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2006.00674.x
更新日期:2007-06-01 00:00:00
abstract::Despite advances in therapy for acute leukemia, relapse continues to be the major cause of treatment failure. Hematopoietic stem cell transplant can rescue some patients after relapse, but the ability to escalate the intensity of preparative regimens is limited by toxicity to normal organs. Radiolabeled monoclonal ant...
journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-3046.7.s3.14.x
更新日期:2003-01-01 00:00:00
abstract::Thrombosis after kidney transplantation may result in catastrophic outcomes, including graft loss. Thrombophilia has been implicated in post-transplant thrombosis; data, however, are inconclusive on the impact of acquired and inherited thrombophilia and resultant thrombosis in renal graft recipients. We aimed to evalu...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13314
更新日期:2019-02-01 00:00:00
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::CV disease is the major cause of death in patients with CKD. Recently, CMR imaging emerges as a complementary method providing advantages in cardiac assessment; however, data on CMR in pediatric CKD are scarce. We performed CMR in 15 children: two with CKD, six on peritoneal dialysis, seven on hemodialysis, and in 18 ...
journal_title:Pediatric transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-3046.2012.01672.x
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:ADH is a rare and potentially fatal complication following LT. In this study, a systematic review was completed to identify risk factors which may contribute to ADH. METHODS:Transplant databases at three LT programs were reviewed. Four pediatric and zero adult cases were identified. Next, a systematic revie...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13296
更新日期:2018-12-01 00:00:00