Association Between Early Immunosuppression Center Variability and One-Year Outcomes After Pediatric Liver Transplant.

Background: Despite the existence of institutional protocols, liver transplant centers often have variability in early immunosuppression practices. We aimed to measure within-center variability in early immunosuppression after pediatric liver transplant (LT) and examine its association with one-year outcomes.

Methods: We analyzed pediatric LTs from 2013 to 2018 in the United Network for Organ Sharing registry, with data aggregated by center.

Factors associated with thrombotic and hemorrhagic complications in pediatric liver transplant: A multi-center analysis from the Starzl Network for Excellence in Pediatric Transplantation.

Background: Survival after pediatric liver transplantation (PLT) is negatively impacted by thrombotic and hemorrhagic complications. Limited data exists regarding factors associated with these complications and utilization of anticoagulation.

Methods: Retrospective review of donor, recipient variables and outcomes from four centers participating in the Starzl Network for Excellence in Pediatric Transplantation.

A quality improvement intervention to decrease the decline in renal function in pediatric liver transplant recipients.

Background: Chronic kidney disease (CKD) impacts long-term morbidity in pediatric liver transplant (LT) recipients. The prevalence of estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m (eGFR < 90) at our institution was 25% at 1 year post-LT; thus, quality improvement (QI) project was initiated, aiming to decrease the prevalence of eGFR < 90 by at least 20% at 1 year-post LT.

Post-transplant eosinophilic gastrointestinal disorders and lymphoproliferative disorder in pediatric liver transplant recipients on tacrolimus.

Aim: To examine and characterize post-transplant eosinophilic gastrointestinal disorders (PTEGID) and post-transplant lymphoproliferative disorder (PTLD) in pediatric liver transplant recipients.

Methods: This is a single center retrospective study of all liver transplant recipients aged 0-18 years from 1999 to 2019 who received tacrolimus as their primary immunosuppressant. Demographic data and clinical/laboratory data including PTEGID, PTLD, liver transplant types, Epstein-Barr virus status, and blood eosinophil count were reviewed.

Efficacy and Tolerance of Blended Diets in Children Receiving Gastrostomy Feeds.

Background: To determine the prevalence of gastrointestinal (GI) symptoms in children receiving a blended diet via a gastrostomy tube.

Methods: This is a single-center, retrospective study of children ages 1-18 years that received a blended diet. We reviewed demographics, anthropometrics, clinical characteristics, and rationale for switching to blended diet.

Systemic manifestations of extraskeletal myxoid chondrosarcoma associated with a novel t(2;22)(q34;q12) EWS translocation in a child and a review of the literature.

Extraskeletal myxoid chondrosarcoma (EMC), a soft-tissue sarcoma with unique clinicopathologic features and characteristic chromosomal translocations, is extremely rare in the pediatric population. We, herein, present the case of a 7-year-old boy with profound microcytic hypochromic anemia, poor weight gain and a mid-thoracic paraspinal mass that was identified as EMC. Systemic manifestations of localized, nonmetastatic EMC have never been described in the pediatric population, yet our patient's anemia and poor weight gain resolved after successful surgical resection of the tumor, suggesting that localized EMC can present with systemic manifestations.

The management of hepatitis B and hepatitis C in children.

In the present paper, we review the increased disease burden of hepatitis B (HBV) and hepatitis C (HCV) infection that is recognized worldwide; especially in children when the most common mode of transmission is vertically from infected mothers. In children with HBV and HCV infection, spontaneous clearance of the virus in the first years of life is not common, in contrast with adults, but these patients often stay asymptomatic until early adulthood, when disease has progressed to chronic hepatitis with increased risk of cirrhosis and its complication, and hepatocellular carcinoma. Due to limited treatment options of HBV infection in the pediatric population, clinicians focus on primary prevention, by vaccinating all infants during their first days of life.

Internal Hernia as a Cause for Intestinal Obstruction in a Newborn.

Background: An internal hernia is a rare cause of intestinal obstruction, which can occur at any age. Children most often develop an internal hernia due to a congenital defect in the mesentery. While some patients are asymptomatic, others present to medical attention with vague abdominal symptoms, an acute abdomen, or in shock.