Article
Medicine, General & Internal
Olga Mulas, Fabio Efficace, Maria Grazia Orofino, Antonio Piroddi, Eugenia Piras, Adriana Vacca, Susanna Barella, Alessandro Costa, Johannes M. Giesinger, Giorgio La Nasa, Giovanni Caocci
Summary: This study investigated the health-related quality of life (HRQoL) of pediatric patients with beta thalassemia major (beta-TM) after hematopoietic stem cell transplantation (HSCT), compared to those treated with blood transfusions. The results showed that HSCT was associated with a higher HRQoL in various domains, and there was no significant difference in HRQoL between sibling or unrelated HLA-matched HSCT. The study highlights the importance of considering HSCT as a treatment option for pediatric patients with beta-TM and provides valuable information for physicians to counsel patients and parents.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Davide Cussa, Angelica Pino, Silvia Catalano, Chiara Montini, Federico Assanti, Licia Peruzzi, Michele Pinon, Pier Luigi Calvo, Marco Spada, Damiano Patrono, Fabrizio Gennari, Jean-Bernard Otte, Mauro Salizzoni, Renato Romagnoli
Summary: This study examined the survival and psychosocial outcomes of 40 pediatric liver transplant patients and found that they had excellent long-term survival and good health-related quality of life (HR-QOL). However, support is needed to improve psychological health and living environment.
UPDATES IN SURGERY
(2023)
Article
Critical Care Medicine
Elizabeth Y. Killien, Frederick P. Rivara, Leslie A. Dervan, Mallory B. Smith, R. Scott Watson
Summary: The study aims to evaluate the decline in health-related quality of life following pediatric critical care and determine which individual elements contribute most to this decline. The findings suggest that emotional, physical, energy, activity, sleep, and fear categories are commonly affected. Patient age and baseline health status were also found to impact the risk of decline.
CRITICAL CARE MEDICINE
(2022)
Article
Medicine, General & Internal
Yue-Xian Shi, Hai-Ming Zhang, Jing Chen, Ya-Qi Huang, Ming-Ming Yu, Yin-Hui Jin, Wen-Ru Wang, Wei Gao
Summary: The study indicates that the majority of living liver donors in mainland China have good quality of life outcomes, but attention should still be paid to the impact of donation on physical functions. Short-term post-donation and male recipients were found to be associated with poorer physical-related quality of life.
FRONTIERS IN MEDICINE
(2021)
Article
Immunology
Louisa Katharina Lund, Enke Freya Grabhorn, Darius Ruether, Angela Buchholz, Melanie Lang, Uta Herden, Lutz Fischer, Martina Sterneck
Summary: This retrospective analysis studied 120 young adult patients who underwent liver transplantation in childhood. The study found that the ideal outcome rate decreased over time, with the main complications including chronic kidney disease, elevated liver enzymes, and arterial hypertension. Reduced drug adherence was noted in 24.8% of patients and was significantly associated with donor-specific antibodies, elevated transaminases, and chronic rejection. Additionally, 15% of patients had a psychiatric disease.
Review
Medicine, General & Internal
Amber Hager, Diana Mager, Cheri Robert, David Nicholas, Susan Gilmour
Summary: The study found that there is a certain consistency in parental and child perceptions of HRQOL in pediatric liver transplant recipients, but it is related to age and ethnicity. When children have comorbidities related to mental and neurocognitive development, there may be differences in how parents and children perceive HRQOL.
Article
Public, Environmental & Occupational Health
Leigh R. Tooth, Katrina M. Moss, Gita D. Mishra
Summary: This study found that the longer the average screen time of all children in the family, the worse the child's behavior, while the greater the deviation of the child's screen time from their siblings, the poorer their HRQOL. Family contextual factors should be taken into consideration in both screen time research and recommendations.
PREVENTIVE MEDICINE
(2021)
Article
Health Care Sciences & Services
Louis Onghena, Frederik Berrevoet, Aude Vanlander, Hans Van Vlierberghe, Xavier Verhelst, Eric Hoste, Carine Poppe
Summary: This study investigated illness cognitions and quality of life before and after liver transplantation. The results showed that liver transplant patients had reduced feelings of helplessness and increased acceptance cognitions after the operation. Quality of life decreased in the first 3 months after transplantation and then started to improve, reaching the highest point at 1 year post-transplantation. Patients with pre-transplant ascites experienced significantly less helplessness at 2 years post-transplantation, while those with a pre-transplant MELD score less than 20 had significantly better mental quality of life at 2 years post-transplantation.
QUALITY OF LIFE RESEARCH
(2022)
Article
Public, Environmental & Occupational Health
Neziha Karabulut, Kezban Koras, Dilek Gurcayir
Summary: The study found a significant increase in all subscale scores of males on the IIEF scale after liver transplantation (p=0.000). Although the total FSFI score of females showed an increasing trend before and after transplantation, the results were not statistically significant (p=0.072). Both males and females showed a highly significant increase in the Physical and Mental Component Summary subscale scores of the SF-36 after transplantation (p=0.000).
PSYCHOLOGY HEALTH & MEDICINE
(2022)
Review
Medicine, General & Internal
Aarohanan Raguragavan, Dujinthan Jayabalan, Akshat Saxena
Summary: This systematic review examines the impact of lung transplantation on health-related quality of life in patients with cystic fibrosis (CF). The findings suggest that lung transplantation improves the quality of life for CF patients with advanced-stage pulmonary disease, with levels comparable to the general population up to five years postoperatively. These results provide valuable insights into the best practice of lung transplantation for end-stage CF patients.
Review
Gastroenterology & Hepatology
Alyson Kaplan, Marko Korenjak, Robert S. Brown Jr
Summary: With the improvement in post-transplant patient and graft survival, there is a need to focus on patient experience and health-related quality of life (HRQOL). Liver transplantation can save lives but may come with morbidity and complications. Patient HRQOL improves after transplantation but may not reach the level of age-matched cohorts. Understanding factors such as physical and psychological health, immunosuppression, medication adherence, employment or school, financial burden, and expectations can help in developing interventions to improve HRQOL.
JOURNAL OF HEPATOLOGY
(2023)
Article
Medicine, General & Internal
Shekhar Saha, Ralitsa Mladenova, Caroline Radner, Konstanze Maria Horke, Joscha Buech, Philipp Schnackenburg, Ahmad Ali, Sven Peterss, Gerd Juchem, Maximilian Luehr, Christian Hagl, Dominik Joskowiak
Summary: This study compares the long-term outcomes and health-related quality of life (HRQOL) of patients undergoing surgery for infective native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). The results show significant differences in various domains of HRQOL between NVE and PVE patients, as well as in comparison to healthy individuals.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Oncology
Clarissa E. Schilstra, Karen McCleary, Joanna E. Fardell, Mark W. Donoghoe, Emma McCormack, Rishi S. Kotecha, Richard De Abreu Lourenco, Shanti Ramachandran, Ruelleyn Cockcroft, Rachel Conyers, Siobhan Cross, Luciano Dalla-Pozza, Peter Downie, Tamas Revesz, Michael Osborn, Frank Alvaro, Claire E. Wakefield, Glenn M. Marshall, Marion K. Mateos, Toby N. Trahair
Summary: This study aims to investigate the treatment-related toxicities (TRTs) and impaired quality of life during pediatric acute lymphoblastic leukemia (ALL) therapy, compare the outcomes of different treatment methods, and evaluate their impacts on children and parents.
Article
Oncology
Ryota Hamada, Yohei Oshima, Susumu Sato, Yuji Yoshioka, Manabu Nankaku, Tadakazu Kondo, Toyofumi F. Chen-Yoshikawa, Ryosuke Ikeguchi, Daisuke Nakajima, Hiroshi Date, Shuichi Matsuda
Summary: The study found that patients with LONIPC after lung transplantation showed poor recovery of HRQoL, especially in terms of physical function. Patients who successfully reintegrated into society were usually younger with better performance status, but being unemployed before transplant continued to impact HRQoL.
SUPPORTIVE CARE IN CANCER
(2022)
Article
Multidisciplinary Sciences
Anjiang Lei, Huaxuan You, Biru Luo, Jianhua Ren
Summary: The study found that women in infertile couples experience higher levels of overall stress compared to men, with women also scoring higher on desired family adaptability, cohesion dissatisfaction, and adaptive dissatisfaction. Men and women living in rural areas with lower education levels had higher infertility-related stress, with family cohesion and education level negatively correlated with stress in men, and family adaptability and education level negatively correlated with stress in women. Healthcare providers should pay more attention to and support infertile couples living in rural areas or with low education levels, and focus on the importance of family function and support in reducing infertility-related stress.
SCIENTIFIC REPORTS
(2021)
Article
Pediatrics
Vikram K. Raghu, Rita Sico, Jeffrey A. Rudolph, George Mazariegos, Judy Squires, James E. Squires
Summary: This study provides the first report of sarcopenia in pediatric intestinal transplantation, finding a high prevalence without association with worse outcomes. Sarcopenic patients may have improved graft survival, with potential underlying mechanisms for further exploration.
PEDIATRIC TRANSPLANTATION
(2022)
Editorial Material
Gastroenterology & Hepatology
Kyle A. Soltys, George V. Mazariegos
LIVER TRANSPLANTATION
(2022)
Article
Gastroenterology & Hepatology
James E. Squires, Jacob Bilhartz, Kyle Soltys, Einar Hafberg, George Mazariegos, Nitika A. Gupta, Ravinder Anand, Sarah G. Anderson, Tamir Miloh
Summary: With advances in surgical techniques and medical management, children who receive a liver transplantation can expect remarkable outcomes early after transplant. However, long-term graft loss and mortality rates have not improved. Despite changes in patient selection and no significant improvement in perioperative complications, significant improvements in graft loss and a trend towards improvement in mortality were observed in a more contemporary cohort of children receiving a liver transplantation.
LIVER TRANSPLANTATION
(2022)
Article
Gastroenterology & Hepatology
Michelle A. Wood-Trageser, Drew Lesniak, Alessandro Gambella, Kayla Golnoski, Sandy Feng, John Bucuvalas, Alberto Sanchez-Fueyo, A. Jake Demetris
Summary: The detection of immune pairs (iPAIRs) by next-generation pathology (NGP) can predict the failure of immunosuppression weaning in pediatric liver transplant recipients. The presence and importance of immune synapse formation in liver allografts have been confirmed, and it can be used to adjust immunosuppressive therapy and provide more information through gene analysis.
Article
Gastroenterology & Hepatology
Jennifer Vittorio, Beverly Kosmach-Park, Lindsay Y. King, Ryan Fischer, Emily M. Fredericks, Vicky L. Ng, Amrita Narang, Sara Rasmussen, John Bucuvalas
Summary: Advancements in medical therapies and liver transplantation have allowed more pediatric patients to reach adulthood, but the transition from pediatric to adult hepatology and transplant services poses increased risks. Health care transition (HCT) is the process of shifting from child/family-centered care to adult/patient-centered care. This paper presents joint consensus guidelines to facilitate a structured, multidisciplinary approach to transition planning and calls for the implementation of an HCT program across pediatric and adult hepatology and transplant centers.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2023)
Editorial Material
Gastroenterology & Hepatology
George V. Mazariegos, Kyle A. Soltys, Emily R. Perito
LIVER TRANSPLANTATION
(2023)
Editorial Material
Pediatrics
George V. Mazariegos, Rakesh Sindhi, Armando Ganoza, Kyle Soltys
PEDIATRIC TRANSPLANTATION
(2023)
Review
Pediatrics
Lisa Remaley, Chethan Ashokkumar, Kyle A. Soltys, George Vincent Mazariegos, Geoffrey James Bond, Ajai Khanna, Armando Ganoza, Miguel Reyes-Mugica, Adriana Zeevi, Rakesh Sindhi
Summary: This study reports a third case of operational tolerance after intestine transplantation, confirming donor-specific hyporesponsiveness in the recipient. The three cases of operational tolerance share common characteristics of a relatively large donor antigenic load transmitted during transplantation and donor-specific hyporesponsiveness. Enhanced donor-induced apoptosis of recipient T-cells may be a mechanistic link between antigenic load and donor-specific hyporesponsiveness.
PEDIATRIC TRANSPLANTATION
(2023)
Article
Surgery
Masaki Yamada, Camila Macedo, Kevin Louis, Tiange Shi, Douglas Landsittel, Christina Nguyen, Masayoshi Shinjoh, Marian G. Michaels, Brian Feingold, George V. Mazariegos, Michael Green, Diana Metes
Summary: Chronic Epstein-Barr virus (EBV) infection is a significant problem after pediatric organ transplantation, especially in heart transplant recipients with high viral load. This study analyzed the immune characteristics of CD8(+)/CD4(+) T cells in pediatric heart, kidney, and liver transplant recipients, and identified distinct phenotypic and transcriptomic profiles in heart HVL carriers. The results suggest different incidences of EBV complications and provide insights for risk stratification and clinical management in different types of transplant recipients.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Gastroenterology & Hepatology
George V. Mazariegos, Emily R. Perito, James E. Squires, Kyle A. Soltys, Adam D. Griesemer, Sarah A. Taylor, Eric Pahl
Summary: This retrospective analysis of OPTN data from 2004 to 2020 evaluated the impact of technical variant grafts (TVGs) on waitlist and transplant outcomes for pediatric liver transplant candidates. The study found that higher utilization of TVGs, particularly from deceased donors or living donors, was significantly associated with lower waitlist mortality. Therefore, increasing the utilization of TVGs is critical to decrease waitlist mortality.
LIVER TRANSPLANTATION
(2023)
Review
Pediatrics
Vikrant Sood, Eliza J. Lee, Vikram Raghu, Miguel Reyes-Mugica, Claudia M. Salgado, James Squires, George Mazariegos
Summary: This study presents a unique case of using A1ATD heterozygote donors for pediatric patients with A1ATD, providing initial evidence that it is safe and effective, thereby expanding the donor pool.
PEDIATRIC TRANSPLANTATION
(2023)
Article
Pediatrics
Kyle Soltys, Caroline Lemoine, Xingyu Zhang, Rukhmi Bhat, John Bucuvalas, Sara Rasmussen, Rene Romero, Irini Batsis, Blayne Sayed, John Tunno, Cassandra Confair, Sarah Vargas, Riccardo Superina, George Mazariegos
Summary: Thrombotic and hemorrhagic complications after pediatric liver transplant often affect the survival rate. Limited data exists regarding factors associated with these complications and utilization of anticoagulation. This study reviewed donor, recipient variables and outcomes from four centers and found that intraoperative hepatic artery thrombosis and recurrent postoperative thrombosis were associated with lower hepatic arterial flows and donor variant anatomy.
PEDIATRIC TRANSPLANTATION
(2023)
Review
Gastroenterology & Hepatology
Christian Appenzeller-Herzog, Aurelie Rosat, Tim Mathes, Alberto Baroja-Mazo, Andrzej Chruscinski, Sandy Feng, Ignacio Herrero, Maria-Carlota Londono, George Mazariegos, Hidenori Ohe, Jose A. Pons, Alberto Sanchez-Fueyo, Kayo Waki, Julien Vionnet
Summary: Pre-withdrawal time has a significant impact on the success or failure of immunosuppression withdrawal in liver transplant recipients, according to a systematic review and meta-analysis.
LIVER INTERNATIONAL
(2023)
Review
Pediatrics
Swati Antala, Joseph DiNorcia, John Bucuvalas
Summary: The goal in the care of pediatric liver transplant recipients is to optimize allograft and patient health. Precision medicine and individualized immunosuppression play a crucial role in balancing allograft health and medication side effects. Challenges include predicting allograft health and identifying operational tolerance. More research is needed to determine the clinical utility of innovative tools. Strategies to safely minimize immunosuppression and tailor it in a personalized way are possible, but immunosuppression-free transplant is not yet a reality. This review focuses on progress made in individualizing immunosuppression in pediatric liver transplantation for optimal outcomes.
PEDIATRIC TRANSPLANTATION
(2023)
Article
Pediatrics
Wesley Dixon, Emily R. Perito, John Bucuvalas, Sandy Feng
Summary: Although clinicians often measure ALT to assess allograft health in pediatric liver transplant recipients, decisions are usually made based on single values or qualitative trends rather than quantitative aggregation or synthesis. This study aims to develop and test a comprehensive ALT metric that can better guide clinical decision-making and population comparisons. The results show that the integrated ALT metric correlates with allograft function, survival, and drug concentration. Further investigation is needed to validate this novel ALT metric as a predictor of clinical outcomes and descriptor of populations.
PEDIATRIC TRANSPLANTATION
(2023)