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Pediatric Transplantation (pediatric + transplantation)
Selected AbstractsH1N1 influenza A 2009 and pediatric transplantation: Lessons learned and to be learnedPEDIATRIC TRANSPLANTATION, Issue 1 2010Michael Green MD First page of article [source] Abdominal wound closure in liver,intestine pediatric transplantationPEDIATRIC TRANSPLANTATION, Issue 5 2009Fabrizio Panaro MD No abstract is available for this article. [source] Myfortic in pediatric transplantationPEDIATRIC TRANSPLANTATION, Issue 6 2008Lothar Bernd Zimmerhackl No abstract is available for this article. [source] A national conference to determine research priorities in pediatric solid organ transplantationPEDIATRIC TRANSPLANTATION, Issue 2 2008Sharon M. Bartosh Abstract:, The need for evidence-based practice guidelines requires high quality, carefully controlled clinical research trials. This multidisciplinary conference attempted to: identify urgent clinical and research issues, identify obstacles to performing clinical trials, develop concepts for organ-specific and all-organ research and generate a report that would serve as a blueprint for future research initiatives. A few themes became evident. First, young children present a unique immunologic environment which may lead to tolerance, therefore, including young children in immunosuppression withdrawal and tolerance trials may increase the potential benefits of these studies. Second, adolescence poses significant barriers to successful transplantation. Non-adherence may be insufficient to explain poorer outcomes. More studies focused on identification and prevention of non-adherence, and the potential effects of puberty are required. Third, the relatively naive immune system of the child presents a unique opportunity to study primary infections and alloimmune responses. Finally, relatively small numbers of transplants performed in pediatric centers mandate multicenter collaboration. Investment in registries, tissue and DNA repositories will enhance productivity. The past decade has proven that outcomes after pediatric transplantation can be comparable to adults. The pediatric community now has the opportunity to design and complete studies that enhance outcomes for all transplant recipients. [source] C4d in pediatric renal allograft biopsies: A marker for negative outcome in steroid-resistant rejectionPEDIATRIC TRANSPLANTATION, Issue 4 2006Regina Vargha Abstract:, Recently, deposition of C4d, reflecting complement activation via the classical pathway, has been established as marker of antibody-mediated rejection. As C4d can be detected in paraffin sections, it allows for retrospective analysis in populations with low case loads, such as in pediatric transplantation. In this study we re-evaluated consecutive renal transplant biopsies obtained since 1990 in 36 children (18 boys, 18 girls) who had received their allograft (nine living, 27 cadaveric) at an age of 10.12±4.4 yr. Clinical indications for biopsy were 16 acute steroid resistant rejections (ASRs), 11 chronic rejections and nine other diagnoses. Overall, C4d deposition was found in nine cases (25%), eight of them with diagnosed ASR. Six out of these eight allografts were lost during 36 months of clinical follow-up, a significantly higher rate than in C4d-negative biopsies (p<0.05). C4d status therefore turned out to be an excellent predictor for inferior graft survival following ASR. None of the other histopathologic markers were sensitive for humoral rejections. In conclusion, the high prevalence of C4d-positive staining in ASR demonstrates the importance of the humoral part of the immune system in pediatric transplantation. The worse outcome of C4d-positive rejections despite massive immunosuppressive therapy clearly indicates the need for innovative therapies in this high-risk population. [source] Changing trends in pediatric transplantation: 2001 Annual Report of the North American Pediatric Renal Transplant Cooperative StudyPEDIATRIC TRANSPLANTATION, Issue 4 2003Mark R. Benfield This cooperative group now includes over 150 participating medical centers in the United States, Canada, Mexico, and Costa Rica. This report covers the years from 1987 through 2001 and includes data on 7545 renal transplants in 6878 patients. This report demonstrates changing trends in many areas of pediatric transplantation including increasing numbers of African American and Hispanic children receiving transplantation, remarkable improvements in the rate of acute rejection, rejection reversal, and short- and long-term allograft survival. In the most recent cohorts of patients, we now see that 1-yr allograft survival is no different in cadaver donor compared to living donor recipients and in infants compared to all other age groups. However, this analysis also reveals areas of continued challenges including inferior outcomes in African American and adolescent populations, chronic rejection, and the adverse effects of immunosuppression. [source] Historical landmarks in pediatric transplantationPEDIATRIC TRANSPLANTATION, Issue 4 2001S. A. Weber No abstract is available for this article. [source] Culture and Characterization of Human Hepatocytes Obtained after Graft Reduction for Liver Transplantation: A Reliable Source of Cells for a Bioartificial LiverARTIFICIAL ORGANS, Issue 7 2004Mariana Barbich Abstract:, This article describes results obtained when human liver cells obtained from reduced grafts are cultured in a chemically defined medium. Remnants of livers after reduction for pediatric transplantation were processed by a multiple cannulation system through the existing vasculature, which allowed the homogeneous perfusion of collagenase. The graft weight ranged between 55 and 1000 g (median value: 145.6 g). The yield ranged between 0.13 × 106 and 38 × 106 cells/g of tissue (median value 14.73 × 106 cells/g), and the viability was 61.17 ± 27.43%. The total number of cells ranged between 57.6 × 106 and 12 150 × 106 cells (median value: 740 × 106 cells). Cells were cultured for 30 days. Albumin synthesis was observed during the first 2 weeks, with a peak value at day 6 (27.85 ± 1.77 µg/mL). Urea production was detected during the first week (peak value at day 6: 17.12 ± 2.11 mg/dL). Light microscopy showed the presence of cells in a monolayer. Biliary pigments were observed at day 20. By immunohistochemistry, positive cells for albumin, for hepatocyte marker, cytokeratin 19, CD 34, CD 68, and for alpha actin for smooth muscle, were observed. Our results showed that hepatocytes obtained from reduced liver grafts are easily cultured and are able to maintain viability and functionality in vitro. This alternative source of human cells maintained under controlled culture conditions may play an important role in the development of a bioartificial liver. [source] | ||||||||||