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Pretransplant Considerations

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Book cover Solid Organ Transplantation in Infants and Children

Part of the book series: Organ and Tissue Transplantation ((OTT))

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Abstract

The outcomes from pediatric liver transplantation have improved dramatically since its introduction as a lifesaving procedure in the 1980s; however, it remains a complex and demanding surgery, and while it cures chronic liver disease, it creates a variety of new risks associated with the procedure itself and the lifelong need for immunosuppression. Ensuring the best outcomes following liver transplantation requires that transplant professionals closely monitor patients, beginning long before transplant becomes necessary, in order to recognize indications for transplantation, facilitate timely transplant, and minimize the risk of perioperative complications. Particular attention to optimizing nutritional status, recognizing and mitigating cardiac complications associated with liver disease (high cardiac output failure associated with low systemic vascular resistance, diastolic abnormalities, hepatopulmonary syndrome, and portopulmonary hypertension), and aggressive planning to maximize vaccinations and prevent infectious complications is essential to long-term posttransplant health and well-being.

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References

  • Al Hamoudi W, Lee SS (2006) Cirrhotic cardiomyopathy. Ann Hepatol 5:132–139

    PubMed  Google Scholar 

  • Allen UD, Preiksaitis JK (2013) Epstein-Barr virus and posttransplant lymphoproliferative disorder in solid organ transplantation. Am J Transplant 13(Suppl 4):107–120

    Article  CAS  PubMed  Google Scholar 

  • Arguedas MR, Abrams GA, Krowka MJ et al (2003) Prospective evaluation of outcomes and predictors of mortality in patients with hepatopulmonary syndrome undergoing liver transplantation. Hepatology 37:192–197

    Article  PubMed  Google Scholar 

  • Avery RK, Michaels MG (2013) Strategies for safe living after solid organ transplantation. Am J Transplant 13(Suppl 4):304–310

    Article  PubMed  Google Scholar 

  • Bergman H, Ferrucci L, Guralnik J et al (2007) Frailty: an emerging research and clinical paradigm–issues and controversies. J Gerontol A Biol Sci Med Sci 62:731–737

    Article  PubMed  PubMed Central  Google Scholar 

  • Bolukbas FF, Bolukbas C, Horoz M et al (2004) Child-Pugh classification dependent alterations in serum leptin levels among cirrhotic patients: a case controlled study. BMC Gastroenterol 4:23

    Article  PubMed  PubMed Central  Google Scholar 

  • Chin SE, Shepherd RW, Thomas BJ et al (1992) The nature of malnutrition in children with end-stage liver disease awaiting orthotopic liver transplantation. Am J Clin Nutr 56:164–168

    Article  CAS  PubMed  Google Scholar 

  • Chuang JH, Lee SY, Shieh CS et al (2000) Reappraisal of the role of the bilioenteric conduit in the pathogenesis of postoperative cholangitis. Pediatr Surg Int 16:29–34

    Article  CAS  PubMed  Google Scholar 

  • Cystic Fibrosis Foundation. Cystic Fibrosis Foundation Patient Registry 2013 Annual data report. Bethesda.

    Google Scholar 

  • Danziger-Isakov L, Kumar D (2013) Vaccination in solid organ transplantation. Am J Transplant 13(Suppl 4):311–317

    Article  CAS  PubMed  Google Scholar 

  • De BK, Dutta D, Pal SK et al (2010) The role of garlic in hepatopulmonary syndrome: a randomized controlled trial. Can J Gastroenterol 24:183–188

    Article  PubMed  PubMed Central  Google Scholar 

  • Debette-Gratien M, Tabouret T, Antonini MT et al (2015) Personalized adapted physical activity before liver transplantation: acceptability and results. Transplantation 99:145–150

    Article  PubMed  Google Scholar 

  • Deborah Chirnomas S, Geukes-Foppen M, Barry K et al (2008) Practical implications of liver and heart iron load assessment by T2*-MRI in children and adults with transfusion-dependent anemias. Am J Hematol 83:781–783

    Article  PubMed  Google Scholar 

  • Dehghani SM, Shakiba MA, Ziaeyan M et al (2009) Vaccination status in pediatric liver transplant candidates. Pediatr Transplant 13:820–822

    Article  PubMed  Google Scholar 

  • Derusso PA, Ye W, Shepherd R et al (2007) Growth failure and outcomes in infants with biliary atresia: a report from the Biliary Atresia Research Consortium. Hepatology 46:1632–1638

    Article  PubMed  Google Scholar 

  • Desai MS, Zainuer S, Kennedy C et al (2011) Cardiac structural and functional alterations in infants and children with biliary atresia, listed for liver transplantation. Gastroenterology 141:1264–1272,1272 e1–e4

    Google Scholar 

  • Dornelles CT, Goldani HA, Wilasco MI et al (2013) Ghrelin, leptin and insulin in cirrhotic children and adolescents: relationship with cirrhosis severity and nutritional status. Regul Pept 180:26–32

    Article  CAS  PubMed  Google Scholar 

  • Endo M, Watanabe K, Hirabayashi T et al (1995) Outcomes of ileocolic conduit for biliary drainage in infants with biliary atresia; comparison with Roux-en-Y type reconstruction. J Pediatr Surg 30:700–704

    Article  CAS  PubMed  Google Scholar 

  • Englesbe MJ, Terjimanian MN, Lee JS et al (2013) Morphometric age and surgical risk. J Am Coll Surg 216:976–985

    Article  PubMed  PubMed Central  Google Scholar 

  • Fewtrell MS, Noble-Jamieson G, Revell S et al (1994) Intrapulmonary shunting in the biliary atresia/polysplenia syndrome: reversal after liver transplantation. Arch Dis Child 70:501–504

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fishberger SB, Pittman NS, Rossi AF (1999) Prolongation of the QT interval in children with liver failure. Clin Cardiol 22:658–660

    Article  CAS  PubMed  Google Scholar 

  • Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156

    Article  CAS  PubMed  Google Scholar 

  • Greer R, Lehnert M, Lewindon P et al (2003) Body composition and components of energy expenditure in children with end-stage liver disease. J Pediatr Gastroenterol Nutr 36:358–363

    Article  PubMed  Google Scholar 

  • Guimber D, Michaud L, Ategbo S et al (1999) Experience of parenteral nutrition for nutritional rescue in children with severe liver disease following failure of enteral nutrition. Pediatr Transplant 3:139–145

    Article  CAS  PubMed  Google Scholar 

  • Iqbal CW, Krowka MJ, Pham TH et al (2008) Liver transplantation for pulmonary vascular complications of pediatric end-stage liver disease. J Pediatr Surg 43:1813–1820

    Article  PubMed  Google Scholar 

  • Johnston SD, Morris JK, Cramb R et al (2002) Cardiovascular morbidity and mortality after orthotopic liver transplantation. Transplantation 73:901–906

    Article  PubMed  Google Scholar 

  • Kamath BM, Quammie C, Daniel JF et al (2015) Frailty in children: a novel tool that measures the morbidity associated with end-stage liver disease. J Hepatol 62:S815–S815

    Article  Google Scholar 

  • Kotton CN, Kumar D, Caliendo AM et al (2013) Updated international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation 96:333–360

    Article  CAS  PubMed  Google Scholar 

  • Kumar D, Humar A, Plevneshi A et al (2007) Invasive pneumococcal disease in solid organ transplant recipients–10-year prospective population surveillance. Am J Transplant 7:1209–1214

    Article  CAS  PubMed  Google Scholar 

  • Kwong AJ, Fix OK (2015) Update on the management of the liver transplant patient. Curr Opin Gastroenterol 31:224–232

    Article  PubMed  Google Scholar 

  • L’huillier AG, Wildhaber BE, Belli DC et al (2012) Successful serology-based intervention to increase protection against vaccine-preventable diseases in liver-transplanted children: A 19-yr review of the Swiss national reference center. Pediatr Transplant 16:50–57

    Article  PubMed  Google Scholar 

  • Laving A, Khanna A, Rubin L et al (2005) Successful liver transplantation in a child with severe portopulmonary hypertension treated with epoprostenol. J Pediatr Gastroenterol Nutr 41:466–468

    Article  PubMed  Google Scholar 

  • Lindsay I, Johnson J, Everitt MD et al (2015) Impact of liver disease after the fontan operation. Am J Cardiol 115:249–252

    Article  PubMed  Google Scholar 

  • Manzoni D, D’ercole C, Spotti A et al (2007) Congenital heart disease and pediatric liver transplantation: complications and outcome. Pediatr Transplant 11:876–881

    Article  PubMed  Google Scholar 

  • Mcdiarmid SV, Anand R, Lindblad AS et al (2002) Development of a pediatric end-stage liver disease score to predict poor outcome in children awaiting liver transplantation. Transplantation 74:173–181

    Article  PubMed  Google Scholar 

  • Mcneil SA, Malani PN, Chenoweth CE et al (2006) Vancomycin-resistant enterococcal colonization and infection in liver transplant candidates and recipients: a prospective surveillance study. Clin Infect Dis 42:195–203

    Article  PubMed  Google Scholar 

  • Montano-Loza AJ, Duarte-Rojo A, Meza-Junco J et al (2015) Inclusion of sarcopenia within MELD (MELD-Sarcopenia) and the prediction of mortality in patients with cirrhosis. Clin Transl Gastroenterol 6:e102

    Article  PubMed  PubMed Central  Google Scholar 

  • Nightingale S, Ng VL (2009) Optimizing nutritional management in children with chronic liver disease. Pediatr Clin North Am 56:1161–1183

    Article  PubMed  Google Scholar 

  • Noli K, Solomon M, Golding F et al (2008) Prevalence of hepatopulmonary syndrome in children. Pediatrics 121:e522–e527

    Article  PubMed  Google Scholar 

  • Ridaura-Sanz C, Mejia-Hernandez C, Lopez-Corella E (2009) Portopulmonary hypertension in children. A study in pediatric autopsies. Arch Med Res 40:635–639

    Article  PubMed  Google Scholar 

  • Rothenberg SS, Schroter GP, Karrer FM et al (1989) Cholangitis after the Kasai operation for biliary atresia. J Pediatr Surg 24:729–732

    Article  CAS  PubMed  Google Scholar 

  • Rubin LG, Levin MJ, Ljungman P et al (2014) 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 58:e44–100

    Article  PubMed  Google Scholar 

  • Shneider BL, Brown MB, Haber B et al (2006) A multicenter study of the outcome of biliary atresia in the United States, 1997 to 2000. J Pediatr 148:467–474

    Article  PubMed  Google Scholar 

  • Silvestre OM, Bacal F, De Souza RD et al (2013) Impact of the severity of end-stage liver disease in cardiac structure and function. Ann Hepatol 12:85–91

    PubMed  Google Scholar 

  • Sokol RJ, Stall C (1990) Anthropometric evaluation of children with chronic liver disease. Am J Clin Nutr 52:203–208

    Article  CAS  PubMed  Google Scholar 

  • Sorensen LG, Neighbors K, Martz K et al (2014) Longitudinal study of cognitive and academic outcomes after pediatric liver transplantation. J Pediatr 165:65–72 e2

    Article  PubMed  PubMed Central  Google Scholar 

  • Squires RH, Ng V, Romero R et al (2014) Evaluation of the pediatric patient for liver transplantation: 2014 practice guideline by the American Association for the Study of Liver Diseases, American Society of Transplantation and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 59:112–131

    Article  PubMed  Google Scholar 

  • Sullivan JS, Sundaram SS, Pan Z et al (2012) Parenteral nutrition supplementation in biliary atresia patients listed for liver transplantation. Liver Transpl 18:120–128

    Article  PubMed  PubMed Central  Google Scholar 

  • Sultan MI, Leon CD, Biank VF (2011) Role of nutrition in pediatric chronic liver disease. Nutr Clin Pract 26:401–408

    Article  PubMed  Google Scholar 

  • Tandon P, Ney M, Irwin I et al (2012) Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transpl 18:1209–1216

    Article  PubMed  Google Scholar 

  • Tumgor G, Arikan C, Yuksekkaya HA et al (2008) Childhood cirrhosis, hepatopulmonary syndrome and liver transplantation. Pediatr Transplant 12:353–357

    Article  PubMed  Google Scholar 

  • Waits SA, Kim EK, Terjimanian MN et al (2014) Morphometric age and mortality after liver transplant. JAMA Surg 149:335–340

    Article  PubMed  Google Scholar 

  • Willis AD, Miloh TA, Arnon R et al (2011) Hepatopulmonary syndrome in children – is conventional liver transplantation always needed? Clin Transplant 25:849–855

    Article  PubMed  Google Scholar 

  • Xue QL (2011) The frailty syndrome: definition and natural history. Clin Geriatr Med 27:1–15

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ziakas PD, Pliakos EE, Zervou FN et al (2014) MRSA and VRE colonization in solid organ transplantation: a meta-analysis of published studies. Am J Transplant 14:1887–1894

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Angela Lorts

  2. Division of Infectious Diseases/Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA

    Lara Danziger-Isakov

  3. Pediatric Gastroenterology, Hepatolgy and Nutrition, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, 45029, Cincinnati, OH, USA

    Kathleen Campbell

  4. Immunocompromised Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Lara Danziger-Isakov

Authors
  1. Angela Lorts
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  2. Lara Danziger-Isakov
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  3. Kathleen Campbell
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Corresponding author

Correspondence to Angela Lorts .

Editor information

Editors and Affiliations

  1. Department of Surgery, Jefferson Medical College, Wilmington, Delaware, USA

    Stephen P. Dunn

  2. Division of Gastroenterology, Seattle Children’s Hospital, Seattle, Washington, USA

    Simon Horslen

Section Editor information

  1. Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, ON, Canada

    Vicky Lee Ng

  2. Pediatric Liver Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    John Bucuvalas

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© 2018 Springer International Publishing AG, part of Springer Nature

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Lorts, A., Danziger-Isakov, L., Campbell, K. (2018). Pretransplant Considerations. In: Dunn, S., Horslen, S. (eds) Solid Organ Transplantation in Infants and Children. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07284-5_10

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  • DOI: https://doi.org/10.1007/978-3-319-07284-5_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07283-8

  • Online ISBN: 978-3-319-07284-5

  • eBook Packages: MedicineReference Module Medicine

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