Pediatric Transplantation

There is a shortage of donor hearts in Switzerland, especially for pediatric recipients. Our retrospective analysis shows that the most common reason for refusing a pediatric donor heart is lack of compatibility with the recipient. A more generous acceptance seems to be justified in selected patients.

An antifungal regimen of micafungin and nebulized amphotericin B liposomal may be useful at decreasing the duration of elevated liver enzymes in pediatric patients in the immediate post-lung transplant period when compared to voriconazole monotherapy.

Given the variability in pediatric donor heart utilization among OPOs, we examined factors that may explain this variability, including differences in donor medical management, organ quality, and candidate factors.

Assessment of pediatric heart transplant recipients demonstrated lower aerobic capacity and upper body muscle strength and endurance compared to healthy children. Our study suggests the wall sit test is a quick, easy tool that correlates with overall fitness and quality of life which could be utilized in clinical and research settings.

BFC regimen used in haploidentical SCT was administered safely without major transplant-related complications even in symptomatic patients, and neurological symptoms were stabilized after SCT.

Retrospective review of 107 patients with biliary atresia who underwent liver transplant. 13 (12%) had ACLF during the index admission prior to LT. Two (15%) had Grade 1; 4 (30%) had Grade 2; and 7 (55%) had Grade 3 or 4 ACLF. ACLF cohort was younger at time of listing (5[4-8] vs. 9[6-24] months; p<0.001) and at LT (8 [8-11] vs. 16 [10-40] months, p < 0.001) compared to no ACLF group. Intraoperatively, ACLF patients had higher blood loss (40 [20-53] vs. 10 [6-19] ml/kg; p <0.001) and blood transfusion requirements (33[21-69] vs. 18 [7-25] ml/kg; p = 0.004). Postoperatively they needed higher vasopressor support (31% vs. 10.6%; p=0.04) and total hospital stay (106 [45-151] vs. 13 [7-30] days; p= 0.023). Rate of return to the operating room, hospital readmission rates and one-year post-LT survival rates were comparable between the groups.

Patients with HS are at high risk for residual lesions after OHT, which are predictable based on their native anatomy. Diagnosis of these residual lesions requires thoughtful invasive diagnostics. Residual lesions may contribute to the known higher risk of mortality.