The Experts below are selected from a list of 14247 Experts worldwide ranked by ideXlab platform
Robert B. Ettenger - One of the best experts on this subject based on the ideXlab platform.
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relationship among viremia viral infection alloimmunity and nutritional parameters in the first year after Pediatric kidney Transplantation
American Journal of Transplantation, 2017Co-Authors: Robert B. Ettenger, Nancy D Bridges, Hyunsook Chin, Karen Kesler, Paul C Grimm, Elaine F Reed, Minnie M Sarwal, Richard K Sibley, Eileen TsaiAbstract:The Immune Development in Pediatric Transplantation (IMPACT) study was conducted to evaluate relationships among alloimmunity, protective immunity, immune development, physical parameters, and clinical outcome in children undergoing kidney Transplantation. We prospectively evaluated biopsy-proven acute rejection (BPAR), de novo donor-specific antibody (dnDSA) formation, viremia, viral infection, T cell immunophenotyping, and body mass index (BMI)/weight Z scores in the first year postTransplantation in 106 Pediatric kidney transplant recipients. Outcomes were excellent with no deaths and 98% graft survival. Rejection and dnDSAs occurred in 24% and 22%, respectively. Pretransplant cytomegalovirus (CMV) and Epstein-Barr virus (EBV) serologies and subsequent viremia were unrelated to BPAR or dnDSA. Viremia occurred in 73% of children (EBV, 34%; CMV, 23%; BMK viremia, 23%; and JC virus, 21%). Memory lymphocyte phenotype at baseline was not predictive of alloimmune complications. Patients who developed viral infection had lower weight (-2.1) (p = 0.028) and BMI (-1.2) (p = 0.048) Z scores at Transplantation. The weight difference persisted to 12 months compared with patients without infection (p = 0.038). These data indicate that there is a high prevalence of viral disease after Pediatric kidney Transplantation, and underweight status at Transplantation appears to be a risk factor for subsequent viral infection. The occurrence of viremia/viral infection is not associated with alloimmune events.
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ethical issues in Pediatric organ Transplantation edited by rebecca a greenberg aviva m goldberg and david rodriguez arias switzerland springer international publishing 2016 340 pages
American Journal of Transplantation, 2017Co-Authors: Robert B. EttengerAbstract:By the field's very nature, there is a robust literature dealing with ethical issues in solid organ Transplantation. Most of the published literature deals with Transplantation in adults But from the earliest days of Pediatric Transplantation, numerous ethical questions have been raised. This article is protected by copyright. All rights reserved.
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Pediatric Transplantation in the United States, 1996-2005.
American Journal of Transplantation, 2007Co-Authors: Simon Horslen, Mark L. Barr, L. L. Christensen, Robert B. Ettenger, John C. MageeAbstract:Solid organ Transplantation is accepted as a standard lifesaving therapy for end-stage organ failure in children. This article reviews trends in Pediatric Transplantation from 1996 to 2005 using OPTN data analyzed by the Scientific Registry of Transplant Recipients. Over this period, children have contributed significantly to the donor pool, and although the number of Pediatric donors has fallen from 1062 to 900, this still accounts for 12% of all deceased donors. In 2005, 2% of 89 884 candidates listed for Transplantation were less than 18 years old; in 2005, 1955 children, or 7% of 28 105 recipients, received a transplant. Improvement in waiting list mortality is documented for most organs, but pretransplant mortality, especially among the youngest children, remains a concern. Posttransplant survival for both patients and allografts similarly has shown improvement throughout the period; in most cases, survival is as good as or better than that seen in adults. Examination of immunosuppressive practices shows an increasing tendency across organs toward tacrolimus-based regimens. In addition, use of induction immunotherapy in the form of anti-lymphocyte antibody preparations, especially the interleukin-2 receptor antagonists, has increased steadily. Despite documented advances in care and outcomes for children undergoing Transplantation, several considerations remain that require attention as we attempt to optimize transplant management.
Eileen Tsai - One of the best experts on this subject based on the ideXlab platform.
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relationship among viremia viral infection alloimmunity and nutritional parameters in the first year after Pediatric kidney Transplantation
American Journal of Transplantation, 2017Co-Authors: Robert B. Ettenger, Nancy D Bridges, Hyunsook Chin, Karen Kesler, Paul C Grimm, Elaine F Reed, Minnie M Sarwal, Richard K Sibley, Eileen TsaiAbstract:The Immune Development in Pediatric Transplantation (IMPACT) study was conducted to evaluate relationships among alloimmunity, protective immunity, immune development, physical parameters, and clinical outcome in children undergoing kidney Transplantation. We prospectively evaluated biopsy-proven acute rejection (BPAR), de novo donor-specific antibody (dnDSA) formation, viremia, viral infection, T cell immunophenotyping, and body mass index (BMI)/weight Z scores in the first year postTransplantation in 106 Pediatric kidney transplant recipients. Outcomes were excellent with no deaths and 98% graft survival. Rejection and dnDSAs occurred in 24% and 22%, respectively. Pretransplant cytomegalovirus (CMV) and Epstein-Barr virus (EBV) serologies and subsequent viremia were unrelated to BPAR or dnDSA. Viremia occurred in 73% of children (EBV, 34%; CMV, 23%; BMK viremia, 23%; and JC virus, 21%). Memory lymphocyte phenotype at baseline was not predictive of alloimmune complications. Patients who developed viral infection had lower weight (-2.1) (p = 0.028) and BMI (-1.2) (p = 0.048) Z scores at Transplantation. The weight difference persisted to 12 months compared with patients without infection (p = 0.038). These data indicate that there is a high prevalence of viral disease after Pediatric kidney Transplantation, and underweight status at Transplantation appears to be a risk factor for subsequent viral infection. The occurrence of viremia/viral infection is not associated with alloimmune events.
John C. Magee - One of the best experts on this subject based on the ideXlab platform.
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Pediatric Transplantation in the United States, 1997-2006.
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2008Co-Authors: John C. Magee, S. M. Krishnan, Daphne T. Hsu, M R Benfield, Benjamin L. ShneiderAbstract:This article represents the sixth annual review of the current state of Pediatric Transplantation in the United States from the Scientific Registry of Transplant Recipients (SRTR). It presents updated trends, discussion of analyses presented during the year by the SRTR to the committees of the Organ Procurement and Transplantation Network (OPTN) and discussion of important issues currently facing Pediatric organ Transplantation. Unless otherwise stated, the statistics in this article are drawn from the reference tables of the 2007 OPTN/SRTR Annual Report. In this article, Pediatric patients are defined as candidates, recipients or donors aged 17 years or less. Data for both graft and patient survival are reported as unadjusted survival, unless otherwise stated (adjusted patient and graft survival are available in the reference tables). Short-term survival (3 month and 1 year) reflects outcomes for transplants performed in 2004 and 2005; 3-year survival reflects transplants from 2002 to 2005; and 5-year survival reports on transplants performed from 2000 to 2005. Details on the methods of analysis employed may be found in the reference tables themselves or in the technical notes of the 2007 OTPN/SRTR Annual Report, both available online at http://www.ustransplant.org.
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Pediatric Transplantation in the United States, 1996-2005.
American Journal of Transplantation, 2007Co-Authors: Simon Horslen, Mark L. Barr, L. L. Christensen, Robert B. Ettenger, John C. MageeAbstract:Solid organ Transplantation is accepted as a standard lifesaving therapy for end-stage organ failure in children. This article reviews trends in Pediatric Transplantation from 1996 to 2005 using OPTN data analyzed by the Scientific Registry of Transplant Recipients. Over this period, children have contributed significantly to the donor pool, and although the number of Pediatric donors has fallen from 1062 to 900, this still accounts for 12% of all deceased donors. In 2005, 2% of 89 884 candidates listed for Transplantation were less than 18 years old; in 2005, 1955 children, or 7% of 28 105 recipients, received a transplant. Improvement in waiting list mortality is documented for most organs, but pretransplant mortality, especially among the youngest children, remains a concern. Posttransplant survival for both patients and allografts similarly has shown improvement throughout the period; in most cases, survival is as good as or better than that seen in adults. Examination of immunosuppressive practices shows an increasing tendency across organs toward tacrolimus-based regimens. In addition, use of induction immunotherapy in the form of anti-lymphocyte antibody preparations, especially the interleukin-2 receptor antagonists, has increased steadily. Despite documented advances in care and outcomes for children undergoing Transplantation, several considerations remain that require attention as we attempt to optimize transplant management.
Weber L.t. - One of the best experts on this subject based on the ideXlab platform.
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Therapeutic drug monitoring of mycophenolate mofetil in Pediatric patients: novel techniques and current opinion
'Informa UK Limited', 2021Co-Authors: Ehren R., Schijvens A.m., Hackl A., Schreuder M.f., Weber L.t.Abstract:Introduction: Mycophenolate mofetil (MMF) is an ester prodrug of the immunosuppressant mycophenolic acid (MPA) and is recommended and widely used for maintenance immunosuppressive therapy in solid organ and stem-cell Transplantation as well as in immunological kidney diseases. MPA is a potent, reversible, noncompetitive inhibitor of the inosine monophosphate dehydrogenase (IMPDH), a crucial enzyme in the de novo purine synthesis in T- and B-lymphocytes, thereby inhibiting cell-mediated immunity and antibody formation. The use of therapeutic drug monitoring (TDM) of MMF is still controversial as outcome data of clinical trials are equivocal. Areas covered: This review covers in great depth the existing literature on TDM of MMF in the field of Pediatric (kidney) Transplantation. In addition, the relevance of TDM in immunological kidney diseases, in particular childhood nephrotic syndrome is highlighted. Expert opinion: TDM of MMF has the potential to optimize therapy in Pediatric Transplantation as well as in nephrotic syndrome. Limited sampling strategies to estimate MPA exposure increase its feasibility. Future perspectives rather encompass approaches reflecting total immunosuppressive load than single drug TDM
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Therapeutic drug monitoring of mycophenolate mofetil in Pediatric patients: novel techniques and current opinion
'Informa UK Limited', 2021Co-Authors: Ehren R., Schijvens A.m., Hackl A., Schreuder M.f., Weber L.t.Abstract:Contains fulltext : 231550.pdf (Publisher’s version ) (Closed access)Introduction: Mycophenolate mofetil (MMF) is an ester prodrug of the immunosuppressant mycophenolic acid (MPA) and is recommended and widely used for maintenance immunosuppressive therapy in solid organ and stem-cell Transplantation as well as in immunological kidney diseases. MPA is a potent, reversible, noncompetitive inhibitor of the inosine monophosphate dehydrogenase (IMPDH), a crucial enzyme in the de novo purine synthesis in T- and B-lymphocytes, thereby inhibiting cell-mediated immunity and antibody formation. The use of therapeutic drug monitoring (TDM) of MMF is still controversial as outcome data of clinical trials are equivocal. Areas covered: This review covers in great depth the existing literature on TDM of MMF in the field of Pediatric (kidney) Transplantation. In addition, the relevance of TDM in immunological kidney diseases, in particular childhood nephrotic syndrome is highlighted. Expert opinion: TDM of MMF has the potential to optimize therapy in Pediatric Transplantation as well as in nephrotic syndrome. Limited sampling strategies to estimate MPA exposure increase its feasibility. Future perspectives rather encompass approaches reflecting total immunosuppressive load than single drug TDM
Keri Schadler - One of the best experts on this subject based on the ideXlab platform.
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diagnosis grading and management of toxicities from immunotherapies in children adolescents and young adults with cancer
Nature Reviews Clinical Oncology, 2021Co-Authors: Dristhi Ragoonanan, Sajad Khazal, Hisham Abdelazim, David Mccall, Branko Cuglievan, Francesco Paolo Tambaro, Ali Haider Ahmad, Courtney M Rowan, Cristina Gutierrez, Keri SchadlerAbstract:Cancer immunotherapies are associated with remarkable therapeutic response rates but also with unique and severe toxicities, which potentially result in rapid deterioration in health. The number of clinical applications for novel immune effector-cell therapies, including chimeric antigen receptor (CAR)-expressing cells, and other immunotherapies, such as immune-checkpoint inhibitors, is increasing. In this Consensus Statement, members of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Hematopoietic Cell Transplantation-Cancer Immunotherapy (HCT-CI) Subgroup, Paediatric Diseases Working Party (PDWP) of the European Society of Blood and Marrow Transplantation (EBMT), Supportive Care Committee of the Pediatric Transplantation and Cellular Therapy Consortium (PTCTC) and MD Anderson Cancer Center CAR T Cell Therapy-Associated Toxicity (CARTOX) Program collaborated to provide updated comprehensive recommendations for the care of children, adolescents and young adults receiving cancer immunotherapies. With these recommendations, we address emerging toxicity mitigation strategies, we advocate for the characterization of baseline organ function according to age and discipline-specific criteria, we recommend early critical care assessment when indicated, with consideration of reversibility of underlying pathology (instead of organ failure scores) to guide critical care interventions, and we call for researchers, regulatory agencies and sponsors to support and facilitate early inclusion of young patients with cancer in well-designed clinical trials.