Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation

Kelly, Déirdre; Bucuvalas, John C.; Alonso, Estella M.; Karpen, Saul J.; Allen, Upton; Green, Michael; Farmer, Douglas G.; Shemesh, Eyal; McDonald, Ruth A.

doi:10.1002/lt.23697

Cited by 148 publications

(151 citation statements)

References 317 publications

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“…Неспецифический вирусный синдром характеризу-ется лихорадкой, гематологическими изменениями в виде лейкопении, атипичного лимфоцитоза, тром-боцитопении. Тканеинвазивное заболевание мани-фестирует с поражением внутренних органов (же-лудочно-кишечный тракт, печень, легкие) [7,20]. Чаще всего ЦМВ поражает желудочно-кишечный тракт: ЦМВ-гастрит, энтерит, эзофагит, колит, что составляет более 70% среди всех ЦМВ-заболева-ний среди пациентов после трансплантации [21].…”

Section: прямые эффектыunclassified

“…Большинство исследователей приходят к выводу, что в дополнение к прямым эффектам инвазивной инфекции ЦМВИ также ассоциирована с непрямы-ми эффектами: повышение вероятности дисфунк-ции и отторжения трансплантата [17,20,29]. У па-циентов после трансплантации печени показатели выживаемости трансплантата были ниже в случаях регистрации ЦМВИ, чем у пациентов из группы не перенесших данную инфекцию [30,31].…”

Section: непрямые эффектыunclassified

“…При выявлении резистентности к внутривенной терапии ганцикловиром в сочетании с наличием клинических проявлений ЦМВИ или у детей с со-храняющейся или возрастающей ЦМВ-нагрузкой в течение не менее 14 дней на фоне противовирусной терапии рекомендуется дополнительное исследо-вание генотипа резистентного вируса и назначение препаратов второй линии -фоскарнета и цидафо-вира [20].…”

Section: лечение цмвиunclassified

See 2 more Smart Citations

Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

Tsiroulnikova

Жилкин

Ахаладзе

2016

RJTAO

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1 ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация 2 Кафедра трансплантологии и искусственных органов ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова», Москва, Российская Федерация Трансплантация печени является единственным возможным путем лечения многих форм хронических заболеваний печени терминальной стадии у детей. Цитомегаловирус -наиболее распространенная и зна-чимая инфекция у детей после трансплантации печени с развитием эпизодов ЦМВ-инфекции (ЦМВИ) или ЦМВ-заболевания. ЦМВИ ассоциирована с повышенным риском потери трансплантата. В обзоре литературы представлены такие аспекты, как этиология и эпидемиология ЦМВИ после транспланта-ции печени детям, применяемые подходы диагностики и профилактики ЦМВИ, алгоритмы дозирования валганцикловира, а также методы профилактики осложнений течения ЦМВИ. Также представлены по-следние данные о текущих стратегиях профилактики ЦМВИ в мировой практике.Ключевые слова: трансплантация печени детям, цитомегаловирусная инфекция, профилактика цитомегаловирусной инфекции. Liver transplantation is a life-saving procedure for many forms of end-stage liver disease in pediatrics. Cytomegalovirus (CMV) is the most common and signifi cant posttransplant infection after pediatric liver transplant (PLT) with developing an episode of CMV infection or disease. It is well known that CMV increases risk of graft loss. The review presents aspects of etiology and epidemiology of CMV after PLT, approaches employed in diagnostics and prophylaxis of CMV, algorithms for valganciclovir dosing and methods to prevent complications associated with CMV. The latest data on current prevention strategies in pediatric liver transplantation centers in the world are also presented. CLINICAL SIGNIFICANCE OF CYTOMEGALOVIRUS INFECTION IN PEDIATRIC LIVER TRANSPLANT RECIPIENTS

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Section: прямые эффектыunclassified

Section: непрямые эффектыunclassified

Section: лечение цмвиunclassified

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Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

Tsiroulnikova

Жилкин

Ахаладзе

2016

RJTAO

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“…A review of long-term outcomes was included in the recently published American Association for the Study of Liver Diseases guidelines for treatment. 3 The aim of this preliminary study was to evaluate 1 of the largest cohorts of pediatric patients who have undergone liver transplant at a single center in Turkey.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Liver transplant is an established curative therapy for children with chronic end-stage liver disease or acute liver failure. In this study, we aimed to evaluate pediatric liver transplant in terms of outcomes, complications, and long-term followup results. Materials and Methods: Pediatric patients who had liver transplant in our institution were included. We retrospectively evaluated demographic features including body weight, Child-Pugh score, etiology of liver disease, graft source, perioperative outcomes, perioperative complications, postoperative complications, and long-term results. Outcomes of treatment of complications and revision transplant were evaluated. Results: Between September 2001 and December 2013, there were 188 pediatric liver transplants performed in our institution. Most grafts (90.9%) were obtained from living-related donors. There were 13 patients (6.9%) who had an intervention because of a hemorrhage postoperatively. Biliary leakage was observed in 33 patients (17.5%) and biliary stricture during follow-up was observed in 32 patients (17%). Thrombosis rates in the hepatic artery and portal vein were 12.3% and 0.5%. Revision transplant was performed in 11 patients (5.8%); reason for revision transplant was rejection in 50% patients. The remaining children were alive with good graft functioning after treatment of complications and revision transplant. The overall 5-and 10-year survival rates were 82.3% and 78.9%. Conclusions:The overall outcomes of pediatric liver transplant at our center are very promising. With improved care of younger children and the combined efforts of the parents and medical team, the number of the children receiving transplants will increase in the future.

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“…The American Association for the Study of Liver Diseases (AASLD) has recently published 2 guidelines regarding the long-term medical management of pediatric liver transplantation (LT) patients and the evaluation of pediatric patients for LT. 1,2 Both of these guidelines use the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach with minor modifications for evaluating evidence (high to low) and giving recommendations (strong or weak). The original GRADE system 3 is based on 4 evidence-quality levels (high to very low).…”

mentioning

confidence: 99%

Two pediatric liver transplantation guidelines issued by the American Association for the Study of Liver Diseases: A simple survey of their characteristics

Kivelä

2014

Liver Transpl

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Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation

Cited by 148 publications

References 317 publications

Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

Untitled

Two pediatric liver transplantation guidelines issued by the American Association for the Study of Liver Diseases: A simple survey of their characteristics

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