Pediatric Transplantation

The Pediatric Heart Transplant Society database was used to identify all children ≥ 2 years old with failing Fontan or cardiomyopathy who underwent isolated heart transplant 2005–2019. The primary endpoint was postoperative dialysis within the first 30 days. Fontan patients have a ~fivefold higher risk of dialysis compared to cardiomyopathy patients.

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.

Sibling (ages 12–17 years) of kidney and liver transplant recipients affirm that the transplant event is distressing and impacts their relationships and family functioning both in the moment and for years after the transplant. Transplant team members can support siblings through healthcare interactions and a family-inclusive model of care.

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.

Female teenagers have lower survival following heart transplantation than their male counterparts. Male donor—female recipient transplants have the lowest survival among sex-matching groups. The use of organs from oversized or younger donors may be considered to help improve post-transplant survival in teenagers.

In this prospective longitudinal serological survey of COVID-19 antibody in pediatric solid organ transplant recipients, we observed a detectable humoral response following two doses of COVID-19 mRNA vaccine and, importantly, with enhanced responses following additional doses of vaccine, as measured by multiple serologic assays.

Heart transplantation remains an effective therapy in children with a growing number of long-term survivors. Risk factors for mortality in patients ≤ 10 years of age at transplant with conditional survival to 3 years post-transplant include CAV, rejection, malignancy, female sex, and Black race.

In October 2018, the OPTN changed adult heart transplant (HT) allocation policy, increasing the number of adult candidates that had higher priority than pediatric candidates, potentially disadvantaging pediatric waitlist registrants. Mortality on the waitlist decreased and access to HT for pediatric registrants did not decline following the policy change.

Convenience for coordinators and the perceived comfort for adolescents were noted advantages for virtual study visits. Technical issues, periodic adolescent distractions, and challenges with instructional teaching were identified as potential limitations. Researchers should consider the feasibility of completing study-related tasks and ensure adequate training of personnel when implementing virtual visits.

Semilunar valves from the hearts of patients receiving a retransplant can be used for partial heart transplants.

Hispanic and non-Hispanic black (NHB) patients faced longer wait times for kidney transplantation compared to non-Hispanic whites (NHW), with NHB showing lower graft and patient survival. Key predictors of graft loss were identified, highlighting the need to mitigate disparities in wait times and clinical factors to improve outcomes.

Rapid weight gain (RWG) in the first year following kidney transplantation occurred frequently in the North American Pediatric Trials and Collaborative Studies cohort and was significantly associated with obesity but not hypertension up to 5 years post-transplant. RWG was lower in children who received steroid minimization protocols.