Pediatric Transplantation

To better understand the immunosuppression requirements for patients receiving partial heart transplants (PHTs), we investigated the effect of rejection episodes on the aortic and pulmonary valves of patients who received orthotopic heart transplants (OHTs). Compared to patients with no rejection, those who experienced rejection episodes had no clinically significant changes to their pulmonary or aortic valves. Knowing that rejection primarily targets the myocardium and spares the valve, intensive immunosuppression regimens required for graft protection in OHT may not be necessary for semilunar valve protection in PHT.

The majority of pediatric liver transplant (LT) centers across the US now offer live viral vaccines (LVVs) for select LT recipients. However, despite new safety and immunogenicity data and updated recommendations, there continue to be barriers to widespread implementation.

This study surveyed pediatric infectious diseases (PID) clinicians about organ acceptance and associated posttransplantation interventions using fictitious case scenarios. Agreement on donor acceptance was high across many scenarios. However, management variability reveals key opportunities to optimize strategies to reduce the impact of donor-derived infections in organ recipients.

Cidofovir (CDV) prophylaxis significantly reduces the incidence of BK virus-associated hemorrhagic cystitis in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation. Early BKV copy number reduction and lower graft-versus-host disease prevalence in the CDV group suggest its potential as an effective preventive treatment.

It is crucial to consider kidney function and the exposure to valganciclovir vs. dose alone when determining the risk of neutropenia in pediatric solid organ transplant recipients. Utilizing BSA-based dosing, Cystatin C-based GFR estimation, and appropriate upper limits of GFR for age was associated with a lower rate of neutropenia.

This study highlights the low approach rates for potential organ donors and the persistent racial disparities in the pediatric deceased organ donation process. Racial minority groups are less likely to be approached for donation and consent compared to Whites. These findings underscore the need for an equitable organ donation process to expand the pediatric donor pool.

Biliary strictures management costs were highest in patients requiring treatment for recurrence or surgical biliary revision and lowest earlier post-transplant, suggesting that more aggressive management upfront may optimize costs. Future work will explore practice variation and cost-effective strategies to achieve OBO.

Findings suggest that ChatGPT could be a useful tool for adolescents or caregivers to cover general aspects of kidney transplantation. While the overall scores of accuracy and relevancy are impressive, the presence of potentially risky outputs underscores the necessity for human oversight and validation.

Tacrolimus clearance (CL/F) varies with hemoglobin and cholesterol levels in pediatric kidney transplant recipients, as shown in this retrospective study. Lower hemoglobin increases CL/F, while higher cholesterol reduces it, underscoring the potential for biochemical parameters to enhance therapeutic drug monitoring and dosing strategies.

Survival after allogeneic hematopoietic stem cell transplants (aHSCTs) in the state of Florida since the creation of a state pediatric HSCT consortium has improved. This is significant because it demonstrates that small-sized pediatric HSCT centers can work together in a consortium to improve outcomes similar to larger centers.