Pediatric Transplantation

In a review of a national database spanning the past three decades, researchers investigated delayed graft function (DGF) in pediatric recipients of deceased donor kidney transplants. This study found that DGF was associated with reduced survival after cases and controls were matched across various donor, recipient, and transplant factors.

We investigated the factors associated with intraoperative hypothermia in 111 patients who underwent pediatric liver transplantation between 2019 and 2020 at a single tertiary pediatric center. The results of multivariate analysis indicated that only rejection was significantly associated with intraoperative hypothermia during pediatric liver transplantation.

Following liver transplant, 23% of pediatric recipients required rehospitalization within 30 days. Shorter hospital stays were a major risk factor for early hospital readmission, highlighting that longer initial transplant hospital stays may be beneficial for predischarge optimization and coordination of their complex care.

Post-traumatic stress symptoms are highly prevalent in the pediatric solid organ transplant population, as measured by the Child Trauma Screening Questionnaire. Risk factors for post-traumatic stress include recent ICU days, the number of medications, and involvement with the foster care system, whereas higher family functioning appears to be protective.

Although pediatric organ donation represents a small proportion of overall organ donation, children and adolescents make a significant contribution to the pool of donated organs. In this study 252 solid organs were collected from children and adolescent. Two hundred and two recipients benefited from 62 pediatric organ donors, with a recipient/donor ratio of 3.3.

Haploidentical stem cell transplants are promising but should be restricted to leukemia patients first, then benign conditions. Avoid in DSA-positive patients to prevent graft rejection. Use bone marrow as the primary stem cell source to reduce the risk of GVHD.

Based on caregiver interviews, two key findings were identified. First, caregivers emphasized the significantly elevated anxiety that they and their family members experienced during the COVID-19 health emergency concerning a myriad of issues. Second, resilience characteristics and processes were evident in how caregivers negotiated pandemic-related challenges.

Family cohesion and social support from people in school are important in post-transplant health-related quality of life (HRQOL). Relative to comparable samples, transplant recipients reported more optimal family environment, greater teacher social support, and lower social support from close friends. Psychosocial interventions for adolescents should incorporate school supports and family strengths.

Oral mucositis (OM) severity and its impact on changes in body weight are not extensively studied in pediatric patients who have received hematopoietic stem cell transplantation. Busulfan conditioning and methotrexate plus cyclosporin for graft-versus-host disease prophylaxis are the main contributors to OM in patients with nonmalignant and malignant conditions, respectively.

Varicella-zoster virus (VZV) reactivation is the most common infectious complication in the late posthematopoietic stem cell transplantation (HSCT) period and is reported as 16%–41%. Acyclovir prophylaxis is recommended for at least 1 year after HSCT to prevent VZV infections. However, there is less information on pediatric patients and studies on the most appropriate prophylaxis are ongoing.

In autologous patients, transplant-related mortality (TRM) was 0%, with 4 (57%) experiencing disease relapse, resulting in the death of one patient. Additionally, 3 (42.8%) of patients remain alive under second-line management. The overall survival rate was 6 (85.7%), and the disease-free survival rate was 16 (88%). In allogeneic patients, TRM was 5.5% (1/18). One allogeneic patient experienced disease relapse and subsequently died. The overall survival rate and disease-free survival rate were 16 (88%). The objective of this study was to assess the outcomes of pediatric hematopoietic stem cell transplantation (HSCT) patients who have undergone transplantation thus far.

Long-term donor chimerism is associated with the addition of thiotepa in treosulfan-based conditioning for patients with non-malignant conditions. Real-time treosulfan pharmacokinetic assessment is feasible to perform to facilitate next-day dose adjustment.