Liver transplantation during infancy: No increased rate of neurological complications
pLT is a highly standardized therapy for children with end‐stage liver disease and liver‐based metabolic diseases. However, NCs after transplantation occur and especially younger children are considered as more vulnerable and susceptible to NCs. Up to now, detailed data particularly for the very you...
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| Veröffentlicht in: | Pediatric transplantation 2018-12, Vol.22 (8), p.e13304-n/a |
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| creator | Ameres, Markus Melter, Michael Zant, Robert Schilling, Stefan Geis, Tobias |
| description | pLT is a highly standardized therapy for children with end‐stage liver disease and liver‐based metabolic diseases. However, NCs after transplantation occur and especially younger children are considered as more vulnerable and susceptible to NCs. Up to now, detailed data particularly for the very young age group do not exist. We therefore retrospectively studied NCs in children after pLT under age of 24 months. Forty children aged between 19 days and 22 months were evaluated according to type of NC and potential risk factors. NCs occurred in 8/40 patients (20%). All experienced new‐onset seizures and in 1/6 surviving patients, seizures evolved into epilepsy. Other NCs were intracerebral abscess (1/8 patients) and subdural hemorrhage (1/8 patients). The overall 3‐year mortality rate was 10% (4/40 patients). Significant risk factors for NCs and therefore seizures were HAT (P = 0.020), total surgery time (P = 0.009), retransplantation (P |
| doi_str_mv | 10.1111/petr.13304 |
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However, NCs after transplantation occur and especially younger children are considered as more vulnerable and susceptible to NCs. Up to now, detailed data particularly for the very young age group do not exist. We therefore retrospectively studied NCs in children after pLT under age of 24 months. Forty children aged between 19 days and 22 months were evaluated according to type of NC and potential risk factors. NCs occurred in 8/40 patients (20%). All experienced new‐onset seizures and in 1/6 surviving patients, seizures evolved into epilepsy. Other NCs were intracerebral abscess (1/8 patients) and subdural hemorrhage (1/8 patients). The overall 3‐year mortality rate was 10% (4/40 patients). Significant risk factors for NCs and therefore seizures were HAT (P = 0.020), total surgery time (P = 0.009), retransplantation (P < 0.001), period of catecholamine therapy (P = 0.024), period of mechanical ventilation (P = 0.014), and period of sedation (P = 0.010). Our study is the first to provide detailed information on NCs after pLT in children under 24 months of age. The incidence of NCs in this particular group of very young patients was not increased compared to previously published data of children of all ages. Main NC was new‐onset seizure. In the surviving infants, prognosis of seizure was excellent and the risk of developing epilepsy was low. Even more, the occurrence of NCs did not significantly affect mortality or survival in this particular age group.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.13304</identifier><identifier>PMID: 30315619</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Age ; Brain Abscess - complications ; Catecholamines ; Catecholamines - therapeutic use ; Children ; Convulsions & seizures ; End Stage Liver Disease - complications ; End Stage Liver Disease - surgery ; Epilepsy ; Female ; Hematoma, Subdural - complications ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infants ; Liver diseases ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver transplants ; Male ; Mechanical ventilation ; Medical prognosis ; Mortality ; Nervous System Diseases - complications ; Neurological complications ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; seizure ; Seizures ; Seizures - complications ; Surgery</subject><ispartof>Pediatric transplantation, 2018-12, Vol.22 (8), p.e13304-n/a</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-d1f08cc9bd89b4b3a803bdadce0589e0e92c090a03b32e9f00317f9a0c2e8bf43</citedby><cites>FETCH-LOGICAL-c3574-d1f08cc9bd89b4b3a803bdadce0589e0e92c090a03b32e9f00317f9a0c2e8bf43</cites><orcidid>0000-0002-6941-3247 ; 0000-0001-8092-3590 ; 0000-0002-4194-0758 ; 0000-0003-0604-332X ; 0000-0001-5053-5618</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpetr.13304$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpetr.13304$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30315619$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ameres, Markus</creatorcontrib><creatorcontrib>Melter, Michael</creatorcontrib><creatorcontrib>Zant, Robert</creatorcontrib><creatorcontrib>Schilling, Stefan</creatorcontrib><creatorcontrib>Geis, Tobias</creatorcontrib><title>Liver transplantation during infancy: No increased rate of neurological complications</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>pLT is a highly standardized therapy for children with end‐stage liver disease and liver‐based metabolic diseases. However, NCs after transplantation occur and especially younger children are considered as more vulnerable and susceptible to NCs. Up to now, detailed data particularly for the very young age group do not exist. We therefore retrospectively studied NCs in children after pLT under age of 24 months. Forty children aged between 19 days and 22 months were evaluated according to type of NC and potential risk factors. NCs occurred in 8/40 patients (20%). All experienced new‐onset seizures and in 1/6 surviving patients, seizures evolved into epilepsy. Other NCs were intracerebral abscess (1/8 patients) and subdural hemorrhage (1/8 patients). The overall 3‐year mortality rate was 10% (4/40 patients). Significant risk factors for NCs and therefore seizures were HAT (P = 0.020), total surgery time (P = 0.009), retransplantation (P < 0.001), period of catecholamine therapy (P = 0.024), period of mechanical ventilation (P = 0.014), and period of sedation (P = 0.010). Our study is the first to provide detailed information on NCs after pLT in children under 24 months of age. The incidence of NCs in this particular group of very young patients was not increased compared to previously published data of children of all ages. Main NC was new‐onset seizure. In the surviving infants, prognosis of seizure was excellent and the risk of developing epilepsy was low. Even more, the occurrence of NCs did not significantly affect mortality or survival in this particular age group.</description><subject>Age</subject><subject>Brain Abscess - complications</subject><subject>Catecholamines</subject><subject>Catecholamines - therapeutic use</subject><subject>Children</subject><subject>Convulsions & seizures</subject><subject>End Stage Liver Disease - complications</subject><subject>End Stage Liver Disease - surgery</subject><subject>Epilepsy</subject><subject>Female</subject><subject>Hematoma, Subdural - complications</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Liver diseases</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver transplants</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Nervous System Diseases - complications</subject><subject>Neurological complications</subject><subject>Respiration, Artificial</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>seizure</subject><subject>Seizures</subject><subject>Seizures - complications</subject><subject>Surgery</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9Lw0AQxRdRrFYvfgAJeBEhdTa7abLepNQ_UFSkPYfNZrakpNm4myj99m6b6sGDc5nH8JvHzCPkgsKI-rptsLUjyhjwA3JCmRChl-PDnU5CRnk0IKfOrQDomKf8mAwYMBqPqTghi1n5iTZoraxdU8m6lW1p6qDobFkvg7LWslabu-DFeK0sSodFYGWLgdFBjZ01lVmWSlaBMuum8mq77s7IkZaVw_N9H5LFw3Q-eQpnr4_Pk_tZqFic8LCgGlKlRF6kIuc5kymwvJCFQohTgYAiUiBA-imLUGjwZydaSFARprnmbEiue9_Gmo8OXZutS6ew8o-g6VwWUSoEg4SDR6_-oCvT2dpf5ykm4phxSDx101PKGucs6qyx5VraTUYh24adbcPOdmF7-HJv2eVrLH7Rn3Q9QHvgq6xw849V9jadv_em39aKioM</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Ameres, Markus</creator><creator>Melter, Michael</creator><creator>Zant, Robert</creator><creator>Schilling, Stefan</creator><creator>Geis, Tobias</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6941-3247</orcidid><orcidid>https://orcid.org/0000-0001-8092-3590</orcidid><orcidid>https://orcid.org/0000-0002-4194-0758</orcidid><orcidid>https://orcid.org/0000-0003-0604-332X</orcidid><orcidid>https://orcid.org/0000-0001-5053-5618</orcidid></search><sort><creationdate>201812</creationdate><title>Liver transplantation during infancy: No increased rate of neurological complications</title><author>Ameres, Markus ; Melter, Michael ; Zant, Robert ; Schilling, Stefan ; Geis, Tobias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3574-d1f08cc9bd89b4b3a803bdadce0589e0e92c090a03b32e9f00317f9a0c2e8bf43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Brain Abscess - complications</topic><topic>Catecholamines</topic><topic>Catecholamines - therapeutic use</topic><topic>Children</topic><topic>Convulsions & seizures</topic><topic>End Stage Liver Disease - complications</topic><topic>End Stage Liver Disease - surgery</topic><topic>Epilepsy</topic><topic>Female</topic><topic>Hematoma, Subdural - complications</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Liver diseases</topic><topic>Liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver transplants</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Nervous System Diseases - complications</topic><topic>Neurological complications</topic><topic>Respiration, Artificial</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>seizure</topic><topic>Seizures</topic><topic>Seizures - complications</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ameres, Markus</creatorcontrib><creatorcontrib>Melter, Michael</creatorcontrib><creatorcontrib>Zant, Robert</creatorcontrib><creatorcontrib>Schilling, Stefan</creatorcontrib><creatorcontrib>Geis, Tobias</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ameres, Markus</au><au>Melter, Michael</au><au>Zant, Robert</au><au>Schilling, Stefan</au><au>Geis, Tobias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Liver transplantation during infancy: No increased rate of neurological complications</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2018-12</date><risdate>2018</risdate><volume>22</volume><issue>8</issue><spage>e13304</spage><epage>n/a</epage><pages>e13304-n/a</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>pLT is a highly standardized therapy for children with end‐stage liver disease and liver‐based metabolic diseases. However, NCs after transplantation occur and especially younger children are considered as more vulnerable and susceptible to NCs. Up to now, detailed data particularly for the very young age group do not exist. We therefore retrospectively studied NCs in children after pLT under age of 24 months. Forty children aged between 19 days and 22 months were evaluated according to type of NC and potential risk factors. NCs occurred in 8/40 patients (20%). All experienced new‐onset seizures and in 1/6 surviving patients, seizures evolved into epilepsy. Other NCs were intracerebral abscess (1/8 patients) and subdural hemorrhage (1/8 patients). The overall 3‐year mortality rate was 10% (4/40 patients). Significant risk factors for NCs and therefore seizures were HAT (P = 0.020), total surgery time (P = 0.009), retransplantation (P < 0.001), period of catecholamine therapy (P = 0.024), period of mechanical ventilation (P = 0.014), and period of sedation (P = 0.010). Our study is the first to provide detailed information on NCs after pLT in children under 24 months of age. The incidence of NCs in this particular group of very young patients was not increased compared to previously published data of children of all ages. Main NC was new‐onset seizure. In the surviving infants, prognosis of seizure was excellent and the risk of developing epilepsy was low. Even more, the occurrence of NCs did not significantly affect mortality or survival in this particular age group.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30315619</pmid><doi>10.1111/petr.13304</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6941-3247</orcidid><orcidid>https://orcid.org/0000-0001-8092-3590</orcidid><orcidid>https://orcid.org/0000-0002-4194-0758</orcidid><orcidid>https://orcid.org/0000-0003-0604-332X</orcidid><orcidid>https://orcid.org/0000-0001-5053-5618</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Age Brain Abscess - complications Catecholamines Catecholamines - therapeutic use Children Convulsions & seizures End Stage Liver Disease - complications End Stage Liver Disease - surgery Epilepsy Female Hematoma, Subdural - complications Hemorrhage Humans Incidence Infant Infant, Newborn Infants Liver diseases Liver transplantation Liver Transplantation - adverse effects Liver transplants Male Mechanical ventilation Medical prognosis Mortality Nervous System Diseases - complications Neurological complications Respiration, Artificial Retrospective Studies Risk Factors seizure Seizures Seizures - complications Surgery |
| title | Liver transplantation during infancy: No increased rate of neurological complications |
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