A5033921750- Renal Transplantation Outcomes and Treatments
- Renal Diseases and Glomerulopathies
- Organ Transplantation Techniques and Outcomes
- Dialysis and Renal Disease Management
- Organ Donation and Transplantation
- Pregnancy and Medication Impact
- Renal and Vascular Pathologies
- COVID-19 Impact on Reproduction
- Cytomegalovirus and herpesvirus research
- Chronic Kidney Disease and Diabetes
- Transplantation: Methods and Outcomes
- SARS-CoV-2 and COVID-19 Research
- Child Nutrition and Feeding Issues
- Complement system in diseases
- Alcoholism and Thiamine Deficiency
- Electrolyte and hormonal disorders
- COVID-19 Clinical Research Studies
- HIV Research and Treatment
- Adolescent and Pediatric Healthcare
- Muscle and Compartmental Disorders
- Herpesvirus Infections and Treatments
- Polyomavirus and related diseases
- Blood groups and transfusion
Cedars-Sinai Medical Center
2016-2025
University of California, Los Angeles
2023
Phoenix Children's Hospital
2023
Children's Hospital of Orange County
2023
University of Rochester Medical Center
2023
Duke University
2023
ABSTRACT Background Current kidney transplant (KT) policies offer advantages in waiting time and organ allocation priority to pediatric patients waitlisted before 18 years old. This study evaluates the effects of this policy for who are on dialysis before, but not until after, age 18. Methods Patients aged 11–25 between 2001 2022 KT were identified OPTN STAR data file analysis. Cohorts defined by status at listing: Peds if < yo, young adult (YA) ≥ yo; NYOD—not yet or OD—on listing, with...
ABSTRACT In pediatric transplantation, acute rejection is a major contributor of graft failure. Current approaches include kidney biopsy in response to dysfunction and/or the emergence donor‐specific HLA antibodies (DSA). However, associated with potential complications. Thus, there need for non‐invasive diagnostics. Detection donor‐derived cell‐free DNA (dd‐cfDNA, AlloSure) > 1% adult transplants. Here, we evaluate utility dd‐cfDNA identifying allograft patients. Between 10/2017 and...
Treatment options for antibody-mediated rejection (AMR) are limited. Recent studies have shown that inhibition of interleukin-6 (IL-6)/interleukin-6 receptor (IL-6R) signaling can reduce inflammation and slow AMR progression.We report our experience using monthly tocilizumab (anti-IL6R) in 25 pediatric renal transplant recipients with AMR, refractory to IVIg/Rituximab. From January 2013 June 2019, a median (IQR) 12 (6.019.0) doses were given per patient. Serial assessments function, biopsy...
Detection of donor-derived cell-free DNA (dd-cfDNA) reliably identifies allograft rejection in pediatric and adult kidney transplant (KT) recipients. Here, we evaluate the utility dd-cfDNA for monitoring response to treatment among renal recipients suffering graft rejection.58 were enrolled between April 2018 March 2020 underwent initial testing monitor rejection. Allograft biopsy was performed scores >1.0%. Patients with histologically proven formed study cohort appropriate treatment....
Abstract Background An accurate, rapid estimate of glomerular filtration rate (GFR) in kidney transplant patients affords early detection deterioration and timely intervention. This study compared the performance serum creatinine (Cr) cystatin C (CysC)-based GFR equations to measured (mGFR) using iohexol among pediatric recipients. Methods CysC, Cr, mGFR were obtained from 45 patients, 1–18 years old. Cr- CysC-estimated (eGFR) was against Cr-based (Bedside Schwartz, U25-Cr), CysC-based...
Abstract Preformed and de novo donor specific antibodies ( pDSA dn DSA ) are risk factors for ABMR . This study compares the effects of vs in pediatric kidney transplant recipients. Sixteen patients with biopsy‐proven were evaluated. Strong MFI >10 000) was recorded at transplant, rejection, follow‐up. s highest termed iDSA s. Allograft biopsies scored according to Banff 2013 criteria. Seven 16 (44%) had transplant; 9 (56%) developed Patients earlier (median = 63 1344 days, P .017), while...
Abstract Steroid avoidance in pediatric kidney transplants was found effective with extended daclizumab induction. Upon discontinuation of daclizumab, lymphocyte‐depleting agents became used, little comparative data. We assessed outcomes children undergoing low immunologic‐risk deceased donor (DD) using induction antithymocyte globulin (ATG) compared to alemtuzumab. reviewed consecutive DD from January 2015 September 2017 at two centers that used different steroid‐avoidance protocols: ATG...
The role of angiotensin II type 1 receptor antibodies (AT1R-Ab) in pediatric renal transplantation is unclear. Here, we evaluated pre-transplant AT1R-Ab on transplant outcomes the first 5 years. Secondary analysis compared levels by age.Thirty-six patients, 2-20 years old, were divided into two groups: AT1R-Ab- (<17 U/ml; n = 18) and AT1R-Ab+ (≥17 18). eGFR was determined at 6-month, 1-, 2-, 4-year post-transplant. Allograft biopsies performed setting strong HLA-DSA (MFI > 10 000), ≥17 U/ml,...
ABMR remains a significant concern for early graft loss, especially those who are HS against HLA antigens. We sought to determine the risk factors leading in pediatric kidney transplant recipients. From January 2009 December 2015, 16 patients at our center (age range 2-21) were retrospectively reviewed outcomes and ABMR. All received desensitization with high-dose IVIG/rituximab prior transplant. Two groups examined: ABMR+ (n = 7) ABMR- 9). Patient survival was 100%; however, one patient...
Abstract Background Adult kidney transplant recipients (KTRs) fully vaccinated against COVID‐19 have substantial morbidity and mortality related to SARS‐CoV‐2 infection compared with the general population. However, little is known regarding safety efficacy of vaccination series in pediatric KTRs. Methods A multicenter, retrospective observational study was performed across nine transplantation centers. Eligible KTRs were enrolled data collected pertaining incidence severity, graft outcomes...
Viral infections are controlled primarily by viral-specific T cells, raising concern for adequate T-cell response to clear CMV infection in transplant recipients receiving lymphocyte-depleting agents (LDA). We examined the rates of viremia and clearance, seroconversion, CMV-specific CD8+ cell (CMV-Tc) activity with class induction agent received.Retrospective review 45 pediatric renal who received LDA (n = 31) or non-LDA (NLDA; n 14) valganciclovir prophylaxis 6 months post-transplant...
Purpose: We previously reported that a high tacrolimus (TAC) % coefficient of variation (CV%) in pediatric (Ped) kidney transplant (KTx) patients (pts) is associated with acute rejection (Rej), development donor specific antibodies (DSA) and medication nonadherence (MNA). sought to determine the predictive value CV% sirolimus (SLR) and/or TAC on KTx Rej, DSA MNA Ped pts SLR TAC. Methods: Trough levels obtained within 6 month period prior biopsy (Bx) were used 37 Bxs 23 risk pts, 2-18 years...
Abstract Background An accurate, rapid estimate of glomerular filtration rate (GFR) in kidney transplant patients affords early detection deterioration and timely intervention. This study compared the performance serum creatinine (Cr) cystatin C (CysC)-based GFR equations to iohexol (iGFR) among pediatric recipients. Methods CysC, Cr, iGFR were obtained from 45 patients, 1–18 years old. Cr- CysC-estimated (eGFR) was against using Cr-based (Bedside Schwartz, U25-Cr), CysC-based (Gentian CAPA,...
As COVID-19-positive donors are becoming more common, there is an increasing need for the transplant community to evaluate safety and efficacy of organ from a SARS-CoV-2-infected donor.Here we describe outcomes two pediatric kidney recipients who were vaccinated against COVID-19 received their allograft SARS-CoV-2-positive donor.Both did not die COVID-19-related illness; first donor had 1 week symptoms 4 weeks prior donation second was asymptomatic. Donor Ct 33.4 at 3 days 2 with 37.2 16...