Overview of pediatric organ transplantation

Malik, Salma; Kassai, Behrouz; Cochat, Pierre

doi:10.1097/mot.0000000000000224

Cited by 9 publications

(12 citation statements)

References 57 publications

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“…Our group recently published a review that concluded, based on 2 published studies [ 33 , 61 ], that a maximum total rATG dose of 7.5 mg/kg is adequate in children at standard immunological risk receiving CNI-based maintenance therapy [ 13 ]. A lower cumulative dose (but not less than 3.5 mg/kg) may be sufficient in younger, lower-risk patients who are receiving CNI therapy, in view of the increased risk for PTLD in the youngest recipients [ 8 , 13 ], although this has not been assessed clinically. The duration of rATG infusion should not be less than 6 h [ 13 ].…”

Section: Ratg Dosing and Monitoring In Pediatric Heart Transplantatiomentioning

confidence: 99%

“…The youngest children (<6 years) have a lower risk for early or late acute rejection than do older children [ 2 ], while those aged more than 6 years show similar rates of rejection to those of younger adults [ 2 ]. Over-immunosuppression should be avoided in infants due to the higher risk of post-transplant lymphoproliferative disorder (PTLD) than in adults [ 2 , 8 ]. Lastly, the imperative to minimize long-term metabolic complications such as post-transplant diabetes mellitus (PTDM) is more pressing in children, since they will require immunosuppression for many decades, with the additional need to ensure that growth is as normal as possible.…”

Section: Introductionmentioning

confidence: 99%

“…The authors of the present study all represent German-speaking HTx centers experienced in the use of rATG induction. Our group has previously published expert opinion articles concerning the appropriate use of rATG induction in adults undergoing HTx [ 8 ] and proposals for rATG dosing and early maintenance regimens in this setting [ 13 ]. Recognizing the important differences between adult HTx and pHTx and attempts towards patient-orientated tailored immunosuppressive regimens, we aimed to review available studies relating to rATG induction in pHTx, and to consider its role within modern immunosuppressive strategies in this unique population.…”

Section: Introductionmentioning

confidence: 99%

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A Review of Induction with Rabbit Antithymocyte Globulin in Pediatric Heart Transplant Recipients

et al. 2018

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Pediatric heart transplantation (pHTx) represents only a small proportion of cardiac transplants. Due to these low numbers, clinical data relating to induction therapy in this special population are far less extensive than for adults. Induction is used more widely in pHTx than in adults, mainly because of early steroid withdrawal or complete steroid avoidance. Antithymocyte globulin (ATG) is the most frequent choice for induction in pHTx, and rabbit antithymocyte globulin (rATG, Thymoglobulin®) (Sanofi Genzyme) is the most widely-used ATG preparation. In the absence of large, prospective, blinded trials, we aimed to review the current literature and databases for evidence regarding the use, complications, and dosages of rATG. Analyses from registry databases suggest that, overall, ATG preparations are associated with improved graft survival compared to interleukin-2 receptor antagonists. Advantages for the use of rATG have been shown in low-risk patients given tacrolimus and mycophenolate mofetil in a steroid-free regimen, in sensitized patients with pre-formed alloantibodies and/or a positive donor-specific crossmatch, and in ABO-incompatible pHTx. Registry and clinical data have indicated no increased risk of infection or post-transplant lymphoproliferative disorder in children given rATG after pHTx. A total rATG dose in the range 3.5–7.5 mg/kg is advisable.

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Section: Ratg Dosing and Monitoring In Pediatric Heart Transplantatiomentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Review of Induction with Rabbit Antithymocyte Globulin in Pediatric Heart Transplant Recipients

et al. 2018

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“…After transplantation, immunosuppressants become a necessity. Life-long surveillance is needed to detect and diagnose potential problems, such as infections and tumours (Malik et al 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation

Landén,

Olander,

Salmela

et al. 2024

Eur Arch Paediatr Dent

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Purpose Organ transplantation is an effective treatment for children with severe heart, liver, and kidney diseases. These patient groups may have more oral and dental diseases than healthy controls. It is important to eliminate oral infection foci before transplantation and to maintain good oral health to avoid potential post-transplant complications. The aim of this study was to describe and compare oral health in Finnish paediatric heart, liver, and kidney transplant recipients prior to organ transplantation. Methods Eighty-six children who received a heart (n = 21), liver (n = 19), or kidney (n = 46) transplant in Finland during the years 2014–2018 were included in this study. The inclusion criterion was a pre-transplantation oral examination. Oral hygiene, enamel anomalies, and the number of decayed, missing, and filled teeth (dmft/DMFT) were analyzed retrospectively from medical and dental records and compared between the three patient groups. Results Children with liver (p = 0.043) or heart (p = 0.047) disease had higher combined primary and permanent dentition dmft/DMFT scores compared to children with kidney disease. A higher combined dmft/DMFT score was associated with poor oral hygiene (p = 0.005). No significant differences in oral hygiene between the patient groups were found. Furthermore, all patient groups had a high prevalence of developmental dental defects. Conclusion Children with liver or heart disease seem to have a higher combined dmft/DMFT score, indicating a higher prevalence of caries compared to children with kidney disease. Prevention of dental caries, along with promoting a good oral hygiene routine and regular check-ups, is suggested in these patient groups.

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“…Organ transplantation is a life-saving procedure for children suffering from end-stage organ diseases ( 1 ). Immunosuppressive therapy is necessary to prevent the rejection of transplanted organs in children; However, this therapeutic approach renders them highly susceptible to infections ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

A quick algorithmic review on management of viral infectious diseases in pediatric solid organ transplant recipients

Moghadamnia,

Eshaghi,

Alimadadi

et al. 2023

Front. Pediatr.

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Pediatric solid organ transplant is a life-saving procedure for children with end-stage organ failure. Viral infections are a common complication following pediatric solid organ transplantation (SOT), which can lead to increased morbidity and mortality. Pediatric solid organ transplant recipients are at an increased risk of viral infections due to their immunosuppressed state. The most commonly encountered viruses include cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), varicella-zoster virus (VZV), adenoviruses, and BK polyomavirus. Prevention strategies include vaccination prior to transplantation, post-transplant prophylaxis with antiviral agents, and preemptive therapy. Treatment options vary depending on the virus and may include antiviral therapy and sometimes immunosuppression modification. This review provides a Quick Algorithmic overview of prevention and treatment strategies for viral infectious diseases in pediatric solid organ transplant recipient.

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Overview of pediatric organ transplantation

Abstract: It is important to generate registries of pediatric patients with organ transplantation for conducting observational studies, which might provide information for designing future RCTs and new insights toward improving the survival rates and long-term predictors of response.

Cited by 9 publications

References 57 publications

A Review of Induction with Rabbit Antithymocyte Globulin in Pediatric Heart Transplant Recipients

A Review of Induction with Rabbit Antithymocyte Globulin in Pediatric Heart Transplant Recipients

Oral findings in paediatric patients with severe heart, liver, and kidney failure prior to organ transplantation

A quick algorithmic review on management of viral infectious diseases in pediatric solid organ transplant recipients

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