DF of cfDNA has been proposed as a stable marker for cellular injury caused by rejection in several organs including the heart. 1,2 An increased DF during episodes of rejection has been reported in both adult and pediatric heart transplant recipients. 3,4 Limited information exists regarding serial changes in DF in the immediate post-transplant phase. De Vlaminck et al 5 reports that DF declines to baseline at 1-week post-heart transplant. Similarly, in a study of DF following liver transplant, baseline levels were reached somewhere between 7 and 10 days post-transplant. 6 Just as DF has value as a specific marker for graft injury, the total amount of circulating
Adverse effects are common when appetite manipulation is used to wean children off G-tube dependence. Anticipating, monitoring, and having a clear intervention plan in a closely monitored setting are necessary to safely use this method.
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