Pediatric Transplantation

This study compares pediatric liver transplant outcomes between living donor liver transplantation (LDLT) and donation after brain death (DBD), highlighting the impact of cold ischemia time, blood transfusions, and recipient characteristics on postoperative complications and survival rates.

This study examines the oral health of children who have undergone liver transplantation, highlighting dental development delays despite similar caries rates compared to their healthy peers. Findings emphasize the need for integrated dental-medical care, focusing on dental age assessment and early intervention to optimize oral health outcomes in this vulnerable population.

Liver transplantation (LT) significantly improves survival and quality of life for children with primary hyperoxaluria (PH), with favorable long-term outcomes observed in most patients. Despite reductions in urine oxalate levels, challenges such as graft shortages and renal graft loss persist, underscoring the need for ongoing monitoring and care.

In the current era, PJP remains a rare post-transplant complication in pediatric SOT patients. PJP infections are associated with significant morbidity, mortality, and costs. Risk factors for PJP are young age at transplant and heart transplantation. An assessment of individual risk factors should be regularly performed to optimize prevention strategies.

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.

Cardiac allograft tissue concentrations of tacrolimus and mycophenolate acid are correlated with blood levels, whereas those of everolimus showed no correlation. Further, the tissue perfusion efficiencies of tacrolimus and everolimus decreased with age. The relationship between acute cellular rejection and cardiac tissue concentrations could not be elucidated in this study.

This study analyzed 225 pediatric heart transplants performed over a decade in Iran. The 1-year, 3-year, and 5-year survival rates were 85.7%, 79.7%, and 73.9%, respectively. Key mortality risk factors included donor age (HR: 1.04, p=0.03), male donor gender (HR: 2.04, p=0.05), and rituximab treatment (HR: 2.44, p=0.05). These findings provide insights for improving pediatric heart transplant outcomes.

The recurrence rate was high in pediatric patients with PSC, emphasizing the need for tailored management strategies in children. The association between recurrent PSC and immune-activating conditions, including ACR and IBD, suggested that immune modulation strategies should be a priority in recurrence prevention.

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.