Abstract:
INTRODUCTION:Transfusion protocols are not well-studied for pediatric patients with acute liver failure (ALF). This study evaluates the utility of an international normalized ratio (INR)-based transfusion threshold for these patients. METHODS:Forty-four ALF pediatric patients from 2009 to 2018 were reviewed and divided into two groups: (a) a threshold group including patients between 2009 and 2015 who were transfused for an INR above 3.0, per institutional policy (n = 30), and (b) a post-threshold group including patients after 2015 through 2018 who were transfused based on clinical judgment (n = 14). Preoperative INRs, preoperative transfusions, intraoperative transfusions, early reoperation, renal function, graft function and deaths were compared. RESULTS:Liver failure severity was similar between threshold and post-threshold groups. Threshold patients had a lower average INR prior to transplantation, 2.8 (range 1.8-3.8) vs 4.4 (range 2.1-9.0), respectively (P = .01). Twenty-six threshold patients (87%) received preoperative FFP compared with seven post-threshold patients (50%, P = .0088). Two threshold patients (7%) received preoperative cryoprecipitate compared with five post-threshold patients (36%, P = .014). The incidence of pre-transplant bleeding, operative transfusions, and 1-year patient and graft survival did not differ significantly. CONCLUSION:Clinical judgment vs an INR-based threshold for transfusions did not increase perioperative complications in children with ALF.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Lee A,Mendoza J,Brubaker AL,Stoltz DJ,McKenzie R,Bonham CA,Esquivel CO,Gallo AEdoi
10.1111/ctr.13819subject
Has Abstractpub_date
2020-04-01 00:00:00pages
e13819issue
4eissn
0902-0063issn
1399-0012journal_volume
34pub_type
杂志文章abstract::The exact mechanism of acute and chronic allograft rejection still remains unclear. The chemokine SDF-1 as mediator of allograft rejection has been under intensive investigation in liver, cardiac and bone marrow transplantation, whereas in renal transplantation, there are no reports about SDF-1 to date. This study was...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00540.x
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:There is a severe shortage of organs for transplantation worldwide, and Mexico has one of the lowest organ donation rates. In this study, we explored the psychosocial barriers that prevent posthumous organ donation by Mexicans. METHOD:We asked 218 adults who were not willing to be donors to complete the s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13112
更新日期:2017-11-01 00:00:00
abstract::Tacrolimus (TAC) is a useful immunosuppressive agent in the prevention of rejection. However, the blood level between its therapeutic and toxic levels is narrow such that its nephrotoxicity is a problem. Moreover, its bioavailability and pharmacokinetics are highly variable. We experienced a case of acute nephrotoxici...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2000.0140s3030.x
更新日期:2000-01-01 00:00:00
abstract::Inflammatory and metabolic response is an important factor to determine clinical outcomes. However, it remains unknown in children undergoing heart transplantation (HTx). We examined the perioperative changes in the inflammatory and metabolic response markers C-reactive protein (CRP) and prealbumin (PA) in 38 heart-tr...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01566.x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Abnormalities of renal function with long-term implications can persist after acute tubular necrosis (ATN), probably because of permanent loss of nephrons. Residual areas of fibrosis are also observed in the renal cortex post-ATN. In this study, we investigate the interstitial alterations post-ATN using hist...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1046/j.1399-0012.2003.00140.x
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Abnormal mineral metabolism is not uncommon after renal transplant (TXP). In dialysis patients, elevated serum phosphorous (P), calcium (Ca), CaP product, and parathyroid hormone (PTH) are associated with increased morbidity and mortality. The effect of these abnormalities on recipient and graft survival aft...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2007.00690.x
更新日期:2007-07-01 00:00:00
abstract::Temporary portocaval shunt and total hepatectomy is a technique used in the presence of toxic liver syndrome because of fulminant hepatic failure, hepatic trauma, primary non-function (PNF), and eclampsia. We performed this technique on four patients. An indication for anhepatic state was severe hemodynamic instabilit...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01118.x
更新日期:2010-01-01 00:00:00
abstract::The purpose of this study was to compare CsA dose monitoring with trough levels (T0) vs. levels obtained 6 h after the morning dose of CsA (T6), with respect to the incidence of acute rejection and renal dysfunction, and the cumulative dose, as well as the cost of CsA after heart transplantation. Twenty consecutive ad...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-10-01 00:00:00
abstract::Although patients within a transplant program are awaiting or have received disease modifying or curative treatment, they are also facing advanced illness and the possibility of death. The involvement of specialized palliative care services for these patients may improve symptom management and facilitate advance care ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12838
更新日期:2016-12-01 00:00:00
abstract::Low birthweight is linked to hypertension, chronic kidney disease and even end-stage renal disease. We hypothesized that living kidney donors born with lower birthweight may be at increased risk of hypertension, albuminuria, or reduced GFR beyond what is typical following uninephrectomy. Two hundred fifty-seven living...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12321
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:This study aimed to investigate the characteristics of lung transplant recipients requiring additional pleural drainage catheters early post-lung transplantation and to determine the safety and efficacy of intrapleural fibrinolytics in these patients. METHODS:A retrospective review of lung transplant recipi...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13592
更新日期:2019-06-01 00:00:00
abstract::The purpose of this review was to evaluate the case reports with lymphoproliferative disorders exclusively localized in the allograft transplanted kidney. We also report a rare case of diffuse large B-cell lymphoma originated from the lymphocytes of the recipient with exclusive localization in the kidney allograft. We...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00804.x
更新日期:2008-07-01 00:00:00
abstract::The presence of Epstein-Barr virus (EBV), human papilloma virus (HPV), and cytomegalovirus (CMV) was studied in 20 patients who developed malignancies after heart transplantation in the Helsinki University Central Hospital. The tumors were analyzed for the presence of HPV by polymerase chain reaction and for EBV by in...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2001.150506.x
更新日期:2001-10-01 00:00:00
abstract::The importance of the size of the infused marrow cell dose (MCD) was investigated in 274 patients undergoing allogeneic BMT between 1975 and 1990. Among those, 65 had acute myelogenous leukemia (AML), 79 acute lymphoblastic leukemia (ALL), 58 chronic myelogenous leukemia (CML) and 25 severe aplastic anemia (SAA). MC...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract:INTRODUCTION:Alagille syndrome (AGS) is an inherited multisystem disorder, and liver transplantation (LT) may be required in pediatric patients with AGS (P-AGS). There are limited data regarding the outcomes of LT in adults with AGS (A-AGS). AIM:To determine and compare the outcomes of LT in A-AGS vs. P-AGS as well as...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01574.x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:It has been shown that glomerulonephritis (GN) recurrence affects graft survival more than acute rejection. Thus, we assessed allograft survival after biopsy-confirmed diagnosis of acute rejection or recurrent GN in current era of immunosuppression. METHODS:Allograft survival following a biopsy diagnosis of...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13738
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Intraoperative fluid management during laparoscopic donor nephrectomy (LDN) may have a significant effect on donor and recipient outcomes. We sought to quantify variability in fluid management and investigate its impact on donor and recipient outcomes. METHODS:A retrospective review of patients who underwen...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13542
更新日期:2019-06-01 00:00:00
abstract::In the general population, obesity is associated with an increased risk of developing hypertension (HTN), type 2 diabetes mellitus (DM), and end-stage renal disease (ESRD). Therefore, most transplant centers have a body mass index (BMI) threshold for accepting living kidney donors. But there have been no studies of po...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13360
更新日期:2018-09-01 00:00:00
abstract::Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri-transplant dialysis on the long-term mortality of liver transplant recipients. We performed a single-center, retrospective cohort study of 743 adult liver transplants; pat...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2010.01238.x
更新日期:2011-03-01 00:00:00
abstract::During liver transplant (LT), the release of vasoactive substances into the systemic circulation is associated with severe hemodynamic instability that is injurious to the recipient and/or the post-ischemic graft. Crystalloid flush with backward unclamping (CB) and portal blood flush with forward unclamping (PF) are t...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12130
更新日期:2013-07-01 00:00:00
abstract::Nineteen consecutive patients with post-transplant lymphoproliferative disorders (PTLD) in an Asian population were reviewed. The histopathologic diagnoses were monomorphic (CD20-positive diffuse large B-cell lymphoma, n = 14); plasmacytic (n = 1); Burkitt-like (n = 1); natural killer cell lymphoma (n = 1); lymphomato...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01593.x
更新日期:2012-09-01 00:00:00
abstract::We report a 61-yr-old kidney transplant recipient with human Parvovirus B19 (HPV B19) infection presenting as a severe pancytopenia 1 month after transplantation. Bone marrow aspiration revealed severe erythroid hypoplasia with giant and dystrophic proerythroblasts. Bone marrow cells were positive for HPV B19 DNA dete...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1034/j.1399-0012.1999.t01-1-130103.x
更新日期:1999-02-01 00:00:00
abstract:INTRODUCTION:Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this study was to determine whether this policy shortens the DCD donors' life. METHODS:The authors retrospectively analy...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12276
更新日期:2014-01-01 00:00:00
abstract::The aim of this study was to assess the independent association between pre-transplant prescription opioid use and readmission following liver transplantation. We reviewed the medical records of all patients at a single medical center undergoing primary, single-organ, liver transplantation from 2004 to 2014. We assess...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12806
更新日期:2016-10-01 00:00:00
abstract::Using lacerated livers for liver transplantation (LTx) can add an option to the extended donor criteria. We present an LTx case using a severely lacerated liver and review of the literature for reported cases. We used a high-grade lacerated liver from a 19-yr-old brain-dead patient caused by traffic accident. The live...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-0012.2008.00914.x
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:It is unclear whether sirolimus, a newer immunosuppressive agent, widely used in renal transplantation, affects male sex hormone levels or sexual function. METHODS:Sex hormone profiles in male renal transplant recipients were obtained and compared between a sirolimus-treated group and a group not on sirolim...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00257.x
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether bacterial contamination of islets affects graft success after total pancreatectomy with islet autotransplantation (TPIAT). BACKGROUND:Factors associated with insulin independence after TPIAT are inconclusive. Although bacterial contamination does not preclud...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12842
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Mycobacterium tuberculosis (TB) is a common pathogen worldwide, and it may cause significant infection after solid organ transplantation (SOT). We reviewed all reported TB cases to provide an update on its epidemiology, clinical presentation, management, and outcome after SOT. METHODS:MEDLINE, EMBASE, and O...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13259
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Intra-abdominal fibromatosis often involves the mesentery root which is non-resectable by conventional surgery. Multivisceral transplant (MVT), as a potential cure to non-resectable fibromatosis, has rarely been reported and the prognosis is unknown. METHODS:Six patients who underwent MVT for intra-abdomina...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13186
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The pediatric end stage liver disease (PELD) score has been used widely to prioritize children awaiting cadaveric liver transplantation (LTx). To establish the objective parameter for optimal timing of living-related LTx (LRLTx), we have assessed our cases using the PELD score. METHODS:From 1997 to 2002, 24...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00194.x
更新日期:2004-10-01 00:00:00