Central venous catheter repair is associated with an increased risk of bacteremia and central line-associated bloodstream infection in pediatric patients.

Background: Repair of broken central venous catheters (CVCs) is common in pediatric patients. We hypothesized that this practice predisposes to bacteremia and central line-associated bloodstream infections (CLABSI).

Methods: We conducted a retrospective case-crossover study of pediatric patients 1 month to 21 years of age with CVC breakages who underwent a first-time repair at our institution, using repair kits provided by CVC manufacturers.

A contemporary analysis of parenteral nutrition-associated liver disease in surgical infants.

Background/purpose: Despite advances in pediatric nutritional support and a renewed focus on management of intestinal failure, there are limited recent data regarding the risk of parenteral nutrition (PN)-associated liver disease in surgical infants. This study investigated the incidence of cholestasis from PN and risk factors for its development in this population.

Methods: A retrospective review was performed of all neonates in our institution who underwent abdominal surgery and required postoperative PN from 2001 to 2006.

The optimal timing of referral to an intestinal failure program: the relationship between hyperbilirubinemia and mortality.

Purpose: Multidisciplinary treatment of pediatric intestinal failure has shown promising results. However, there are limited data as to the optimal time frame for referral of patients to intestinal failure programs. The aim of this study was to explore the relationship of hyperbilirubinemia at referral with patient outcomes in a multidisciplinary program.

The experience of a regional pediatric intestinal failure program: Successful outcomes from intestinal rehabilitation.

Background: The aim of this study was to evaluate the clinical experience of a regional multidisciplinary intestinal failure program for children established in 2005.

Methods: Data were collected from a prospective internal database. Univariate analyses were performed to compare pre- and post-treatment outcomes.

PD-L1/PD-1 signal deficiency promotes allogeneic immune responses and accelerates heart allograft rejection.

Background: PD-L1, a ligand for programmed death 1 (PD-1), delivers a negative costimulatory signal to T cells and plays a critical role in the regulation of peripheral tolerance.

Methods: We used PD-L1(-/-) mice to evaluate the role of the PD-L1 signal on allogeneic immune responses in vivo and the underlying mechanisms. Heart transplantation was performed from PD-L1(-/-) donors or recipients in major histocompatibility complex fully mismatched mouse combinations.

Medical and surgical management of the pediatric patient with intestinal failure.

Until recently, extreme short bowel due primarily to massive resection in the neonatal period had been considered incompatible with long-term survival. Indeed, parents of infants with midgut volvulus or other causes of very extensive intestinal necrosis still may be informed that resection is futile. The advent of intestinal transplantation as a potential therapy and its evolution into a standard therapy for irreversible intestinal failure have led to changing attitudes regarding these catastrophic gastrointestinal events.