Pediatric Transplantation

Change in allocation of kidneys from pediatric deceased donors before the amendment (PRE) and after the amendment (POST). The proportion of pediatric deceased donor kidneys matched to pediatric recipients increased significantly from 14.7% before the amendment to 90.8% after the amendment.

Pediatric HT recipients with decreased pre- and post-transplant functional status are at higher risk for graft failure and mortality. These patients may benefit from early intervention aimed at improving functional status.

This is the first national study to assess post-HTx educational priorities among adolescent HTx recipients, caregivers of pediatric HTx recipients, and pediatric HTx clinicians. Our data suggest that HTx recipients and caregivers place higher value on educational topics regarding daily life after transplant compared to clinicians.

Organ transplant coordinators face numerous challenges, such as consent-obtaining obstacles, exposure to violence, compassion fatigue, obsessive thoughts, social disruption, and hard work in shadow. The pressure from these challenges can result in job burnout and turnover, leading to additional costs for healthcare systems and ultimately reducing the organ donation rate.

We aimed to compare differences in postoperative cardiopulmonary exercise test outcomes between pediatric patients who had an initial indication for transplant as structural congenital heart disease (CHD) versus cardiomyopathy (CM). Patients with cardiomyopathy performed better on chronotropic measures, which may be related to fewer pre-operative sternotomies.

Although pediatric organ donation represents a small proportion of overall organ donation, children and adolescents make a significant contribution to the pool of donated organs. In this study 252 solid organs were collected from children and adolescent. Two hundred and two recipients benefited from 62 pediatric organ donors, with a recipient/donor ratio of 3.3.

Haploidentical stem cell transplants are promising but should be restricted to leukemia patients first, then benign conditions. Avoid in DSA-positive patients to prevent graft rejection. Use bone marrow as the primary stem cell source to reduce the risk of GVHD.

Left lobe split deceased grafts can achieve the same outcomes as live donor grafts and should be considered in an intention-to-split policy to decrease time on the waiting list for young children when a live donor is not available.

We present our series of LT for MSUD, highlighting their neurodevelopmental profiles and growth aspects within the socio-economic-cultural constraints prevalent in the Indian subcontinent. Despite poorer pre-LT profiles, all children attained new development skills and maintained a stable metabolic profile on an unrestricted protein diet. However, catch-up growth remained suboptimal.

A new anticoagulation protocol has helped reduce hepatic artery thrombosis rates and hospital length of stay in pediatric liver transplant recipients. To achieve better outcomes, recent emphasis has been placed on early extubation, and increased use of split liver grafts, which has successfully expanded the donor pool.

Family cohesion and social support from people in school are important in post-transplant health-related quality of life (HRQOL). Relative to comparable samples, transplant recipients reported more optimal family environment, greater teacher social support, and lower social support from close friends. Psychosocial interventions for adolescents should incorporate school supports and family strengths.

Oral mucositis (OM) severity and its impact on changes in body weight are not extensively studied in pediatric patients who have received hematopoietic stem cell transplantation. Busulfan conditioning and methotrexate plus cyclosporin for graft-versus-host disease prophylaxis are the main contributors to OM in patients with nonmalignant and malignant conditions, respectively.

Varicella-zoster virus (VZV) reactivation is the most common infectious complication in the late posthematopoietic stem cell transplantation (HSCT) period and is reported as 16%–41%. Acyclovir prophylaxis is recommended for at least 1 year after HSCT to prevent VZV infections. However, there is less information on pediatric patients and studies on the most appropriate prophylaxis are ongoing.

Italy lacks an active pDCDD program. To gauge acceptance and anticipate reactions, we surveyed PICU staff attitudes before its launch. Despite limited knowledge, respondents expressed positive attitudes toward pDCDD, supporting Italian legislation on cardiocirculatory death determination and the “dead donor role.”

In autologous patients, transplant-related mortality (TRM) was 0%, with 4 (57%) experiencing disease relapse, resulting in the death of one patient. Additionally, 3 (42.8%) of patients remain alive under second-line management. The overall survival rate was 6 (85.7%), and the disease-free survival rate was 16 (88%). In allogeneic patients, TRM was 5.5% (1/18). One allogeneic patient experienced disease relapse and subsequently died. The overall survival rate and disease-free survival rate were 16 (88%). The objective of this study was to assess the outcomes of pediatric hematopoietic stem cell transplantation (HSCT) patients who have undergone transplantation thus far.

A cystatin-C-based estimated GFR provides a viable substitute for monitoring renal function in pediatric patients with chronic kidney disease. However, it has a lower accuracy than measured GFR and can therefore not replace measured GFR in clinical use.