Pediatric Transplantation

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.

Routine pretransplant PGx testing provides frequently actionable data to optimize posttransplant medication regimens, potentially avoiding adverse effects of medications including tacrolimus, azathioprine, HMG-CoA reductase inhibitors, and dapsone, while also providing important information related to thrombosis risk for VTE prophylaxis.

ARD is prevalent among ESKD children. Younger age, lower BMI Z-scores, HTN, and increased Ca × Ph are risk factors for ARD. ARD frequency decreases on ≥ 6-month follow-up of patients.

This retrospective quality assurance study aimed to investigate the incidence and management of pediatric PTLD among all 457 pediatric solid organ transplant recipients In Norway since 1995. We found a PTLD incidence rate of 4.8% (kidney 4.4%, liver 5.7%, and heart 4.2%) and a fatality rate of 23%.

This study highlights that confirmed infections occurred in 18% of pediatric liver transplant patients, with key risk factors identified. These findings underscore the importance of targeted infection management strategies to improve outcomes in children after liver transplantation.

This study describes the incidence and clinical characteristics of Cytomegalovirus (CMV) reactivation in children undergoing hematopoietic stem cell transplantation (HSCT) in Colombia. Among 166 pediatric recipients, CMV viremia occurred in 28% of patients within 100 days post-transplant, with no significant differences in reactivation rates or treatment outcomes based on donor type. One-year overall survival was 60%, and CMV reactivation did not negatively impact survival outcomes. The findings highlight the need for further research to refine monitoring strategies, particularly in regions using unmanipulated stem cells with PTCy.

In a study of 42 patients with VOD, 50% were diagnosed with TA-TMA (5 clinically, 16 retrospectively). Survival rates at 1 year were 66.7% for VOD only, 60% for VOD+TA-TMA, and 62.5% for VOD+rTA-TMA (p = 0.9582). Understanding these endotheliopathies is vital for improving diagnosis, treatment, and patient outcomes.

An analysis of 98 children with kidney transplants from the Immune Development of Pediatric Transplantation (IMPACT) Trial was conducted to determine the relationship between NK cell phenotypes with infection, alloreactive events, and patient/allograft survival. NK cell phenotypes may be a useful tool to differentiate between infectious and alloimmune events.