Pediatric Transplantation

Invasive fungal infections occurred in nearly one-third of pediatric LT recipients who did not receive antifungal prophylaxis during the early posttransplant. Reexploratory laparotomy and postoperative bacterial infections were key risk factors. Early identification and close monitoring of high-risk patients are essential for improving clinical outcomes.

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.

We analyzed a retrospective, observational cohort of 51 patients with pediatric acute liver failure with severe hepatic encephalopathy (grade III-IV), admitted between 1993 and 2023. The survival rate in patients with present PR was higher compared to patients with absent PR (70% and 29%, respectively). In the absence of PR, the neurological outcome could still be favorable after liver transplantation (LTx) (n = 3/6). Radiologically proven brain herniation was associated with mortality (6/7) or minimally conscious state (1/7), irrespective of undergoing a LTx or not.

Our single-institution 15-year experience with simultaneous bilateral native nephrectomy (BNN) in pediatric patients demonstrates utility and safety. We discuss considerations of BNN relative to timing of transplantation, an area of conversation. We demonstrate that a minimally invasive approach is feasible, and the surgical approach should consider the route of current or planned dialysis.

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.

Survival after allogeneic hematopoietic stem cell transplants (aHSCTs) in the state of Florida since the creation of a state pediatric HSCT consortium has improved. This is significant because it demonstrates that small-sized pediatric HSCT centers can work together in a consortium to improve outcomes similar to larger centers.

Elevated LDH levels, advanced tumor stages, and increased number of involved sites are associated with poor prognosis in post-liver transplantation–Burkitt lymphoma (PLT-BL). Immunosuppression withdrawal is a safe strategy, and that also helps pediatric LT recipients diagnosed with PLT-BL to become free from or to reduce the cumulative toxicity of the immunosuppressant drugs.

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.

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.