PEDIATRIC TRANSPLANTATION儿童移植
PEDIATRIC TRANSPLANTATION(英文缩写 PEDIATR TRANSPLANT),ISSN 1397-3142,eISSN 1399-3046,中文译名:儿童移植 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 1.551 | Q4 |
| 2022 | 1.300 | Q4 |
| 2023 | 1.200 | Q3 |
| 2024 | 1.400 | Q3 |
| 2025 | 1.400 | Q3 |
PEDIATRIC TRANSPLANTATION 最新收录文献
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1. Unilateral Versus Bilateral Native Nephrectomy in Pediatric Kidney Transplant.
PMID:日期:2026-09-01Nephrectomy in pediatric kidney transplantation is still practiced routinely at some institutions. Despite this, the clinical utility of nephrectomy for certain indications such as proteinuria and hypertension on pre- and post-transplant outcomes is unknown. All children who underwent kidney transplant and native nephrectomy between 2009 and 2025 were reviewed for baseline clinical covariates, operative details, and outcomes. Of the study population, 70 patients underwent unilateral nephrectomy and 61 underwent bilateral nephrectomy. The median age at transplant in the unilateral nephrectomy group was 12.5 years [9.3, 15.9] vs. 10.7 [7.1, 14.1] in the bilateral nephrectomy group. Operative time was 351.5 [294.8, 413.8] minutes vs. 353 [292, 420], median hospital length of stay 8 days [7, 11] vs. 11 days [8, 16], complications 8 (11%) vs. 15 (25%), and post-transplant delayed graft function 4 patients (6%) vs. 7 (12%). Rejection occurred in 1 patient per group. In the 18 patients who had a nephrectomy for proteinuria, the change in albumin was similar between groups (0.4 g/dL [-0.1, 0.4] vs. 0 g/dL [-0.2, 0.2]). In the 23 patients who had a nephrectomy for hypertension, the change in antihypertensive medications after transplant was higher in the unilateral nephrectomy group (1.5 medications less [0.8, 2] vs. 0 [0, 1]). For the indications of proteinuria and hypertension, clinical outcomes were similar between bilateral vs. unilateral nephrectomy for individuals who underwent kidney transplantation. These findings support consideration of pursuing fewer bilateral native nephrectomies in these patient populations.
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2. Non-HLA Antibody-Associated Hyperacute Allograft Rejection Following Lung Transplantation.
PMID:日期:2026-09-01Pediatric-onset pulmonary hypertension (PH) is a rare, progressive pulmonary vascular disease associated with high mortality. In cases unresponsive to pharmacological therapy with a severe cardiorespiratory phenotype, lung transplantation (LT) remains the final treatment option. Although LT for pediatric PH is considered a procedure with elevated risk, it has been successfully performed in this population. A 3-year-old boy underwent uncomplicated LT for fulminant TBX4-associated PH and developed hyperacute allograft failure requiring plasmapheresis, augmentation of immunosuppression, and the use of a monoclonal complement inhibitor. Despite extensive treatment the patient died 46 days after LT. Retrospective analysis of the serum sample taken at time of transplant prior to reperfusion was positive for six non-histocompatibility antibodies: Sjogren syndrome antigen B, thyroglobulin, glutathione S-transferase Theta-1, colony stimulating factor 2, intracellular adhesion molecule 1, and interferon gamma that were not present in other pediatric thoracic transplant recipients. Hyperacute allograft rejection is extremely rare in LT recipients and its occurrence in this patient implies the need for further characterization of non-HLA antibody-associated LT rejection.
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3. Intraoperative Continuous Kidney Replacement Therapy With Regional Epoprostenol Anticoagulation During Liver Transplantation in a Child With Severe Gastrointestinal Bleeding.
PMID:日期:2026-09-01Acute kidney injury (AKI) is a significant complication in pediatric liver transplant (LT) patients. This is often exacerbated by liver dysfunction, fluid overload, and metabolic disturbances. Intraoperative continuous kidney replacement therapy (IO-CKRT) is an emerging strategy to manage these complex patients, aiming to stabilize fluid, electrolyte, and acid-base imbalances. Epoprostenol is utilized as an anticoagulant during CKRT to maintain circuit patency, particularly in patients at high risk of bleeding by inhibiting platelet aggregation. However, the use of IO-CKRT with epoprostenol specifically in pediatric LT recipients is poorly documented. We present a case of a 12 year-old girl with biliary atresia and cirrhosis who underwent urgent LT from a deceased donor. She developed hemorrhagic shock and multi-organ failure, necessitating pre-transplant plasmapheresis and subsequent CKRT with epoprostenol. IO-CKRT was maintained during the 12 h LT to manage acid-base balance, electrolyte levels, and volume status. Despite epoprostenol anticoagulation for hemofiltration, no abnormal bleeding occurred in the gastrointestinal or surgical areas during transplantation. Post-transplantation, the patient's inotropic support requirements decreased within 24 h. IO-CKRT effectively achieves fluid and metabolic balance during LT in pediatric patients with AKI, fluid overload, and metabolic issues. Epoprostenol proves to be a safe and effective regional anticoagulation option for CKRT in bleeding patients undergoing LT, preventing site bleeding without systemic complications. This case highlights a unique and important application that warrants further investigation into its broader effectiveness and potential complications in this vulnerable patient population.
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4. Donor-Recipient Size Mismatch, Age at Transplant, and Elevated Donor-Derived Cell-Free DNA % Early After Pediatric Heart Transplant.
PMID:日期:2026-09-01Acute rejection (AR) is a major cause of graft loss after orthotopic heart transplant (OHT). Donor-derived cell-free DNA fraction (dd-cfDNA%) is a noninvasive biomarker for AR but may be elevated without AR. We evaluated associations of donor-recipient size mismatch and recipient age with early dd-cfDNA% in pediatric OHT recipients without AR. This single-center retrospective study evaluated initial dd-cfDNA% testing in pediatric OHT recipients without AR. Size mismatch was assessed using donor-to-recipient body surface area (BSA) ratio, weight ratio, and allograft left ventricular (LV) mass z-score. Associations with dd-cfDNA% were assessed using Spearman correlation and Mann-Whitney U tests; multivariable linear regression adjusted for age. Analyses of size mismatch and recipient age were repeated at the second post-OHT dd-cfDNA assessment. Between 2022 and 2025, 58 pediatric OHT recipients underwent dd-cfDNA% testing; 39 had no rejection. After excluding 2 outliers, 37 remained. Higher first dd-cfDNA% was associated with larger BSA ratio (p = 0.039), BSA ratio ≥ 1.5 (median 0.17% vs. 0.06%, p = 0.0185), larger weight ratio (p = 0.016), LV mass oversizing (median 0.17% vs. 0.06%, p = 0.0196), and younger age (p = 0.008). After age adjustment, neither size mismatch nor age was independently associated with first dd-cfDNA%. No significant associations were observed at the second assessment. Greater donor-recipient size mismatch and younger recipient age were associated with higher first dd-cfDNA% in unadjusted analyses, but not after age adjustment. These exploratory findings support further investigation of size mismatch, recipient age, and early allograft adaptation as potential non-rejection contributors to dd-cfDNA elevation.
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5. Annual Protocol Biopsies for Five Years in a Pediatric Kidney Transplant Program: A Single-Center Retrospective Experience.
PMID:日期:2026-09-01Annual protocol biopsies may detect subclinical injury after pediatric kidney transplantation, but real-world five-year surveillance coverage and clinical yield are uncertain. We assessed coverage, histological yield, management consequences, and histology-function associations. We conducted a retrospective cohort study of all 42 consecutive pediatric kidney transplant recipients transplanted between 2007 and 2017 and followed in a single pediatric nephrology program with annual surveillance biopsies. Analyses were based on accrued recipient-year surveillance opportunities; biopsies performed at scheduled times for a clinical indication were excluded from protocol-biopsy analyses. A random-intercept mixed-effects model related estimated glomerular filtration rate (eGFR) to a study-specific chronicity composite score and post-transplant year. Of 158 accrued surveillance opportunities, a protocol biopsy was attempted at 123 (77.8%); 94/158 (59.5%) opportunities in 36 recipients yielded evaluable histology. Abnormal findings occurred in 15/94 (16.0%) evaluable results, involving 10 recipients, and 4/15 (26.7%) were followed by a documented biopsy-driven management change. Seven abnormalities in years 1-2 occurred in seven different recipients, whereas all eight abnormalities in years 3-5 were confined to three recipients with consecutive abnormal biopsies. Higher chronicity scores were associated with lower concurrent eGFR (β = -4.49 mL/min/1.73 m per score point; 95% CI, -7.16 to -1.82; p = 0.001). Real-world surveillance coverage and interpretable yield were incomplete, and documented management impact was limited. These data do not establish a benefit of uniform annual surveillance and provide a rationale for prospective evaluation of risk-adapted strategies.
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6. Pediatric Repeat Lung Transplantation: A Contemporary Analysis of Trends and Outcomes.
6. 儿童再次肺移植：趋势与结局的当代分析PMID:日期:2026-09-01Repeat lung transplant (re-LTx) is the only life-saving treatment option for those with irreversible allograft failure. Using a multi-institutional registry database, we investigated the prevalence and outcomes of pediatric re-LTx over the past 35 years. A retrospective analysis was performed using the Scientific Registry of Transplant Recipients (SRTR). First-time and repeat pediatric LTx candidates from 1989 to 2024 were identified. Univariate analyses, multivariable Cox regression, and Kaplan-Meier plots were performed for a comprehensive analysis. We identified 1396 primary LTx and 81 re-LTx recipients. The transplant-free survival rates for the primary and re-LTx groups were 80% versus 65% at 1-year (p = 0.004). Re-LTx was a risk factor for worse 1-year post-LTx outcomes (HR 1.82; 95% CI 1.19, 2.8; p = 0.006). The days between primary and re-LTx (< 1 year vs. > 1 year) did not have a statistically significant impact on 1-year post-re-LTx outcomes (HR 0.78; 95% CI 0.28, 2.13; p = 0.63). Those requiring mechanical ventilation (MV) at the time of re-LTx had worse outcomes (HR 2.26; 95% CI 1.14, 4.45; p = 0.02). Unlike children following primary LTx, there was no significant improvement in outcomes over time in children with re-LTx (HR 1.04; 95% CI 0.41, 2.61; p = 0.94 for transplant era 2013-2024 vs. 1989-2000). Clinical outcomes for pediatric re-LTx over the past 35 years in the United States remain significantly inferior compared to those for primary LTx. Given these findings, pediatric re-LTx should carefully be considered and restricted to judiciously selected candidates, ideally prior to the development of MV requirement.
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8. The Palliation of Pediatric Kidney Transplantation.
PMID:日期:2026-09-01To ease without curing-this is the essence of palliation. It is also, fundamentally, the objective of organ transplantation. A new kidney is not a cure but a bridge-a way to ease the symptoms of kidney disease and extend life. By definition, kidney transplantation is a form of palliative care. Yet, this alignment has been lost in some aspects of pediatric kidney transplant care. We examine four aspects of transplant care that reveal ongoing disconnection between patients, families, and clinicians across the transplant journey: the transplant lexicon, approaches to adherence, measures of success, and care transition. Applying core palliative care principles, like meaning, agency, connection, and hope, offers a necessary paradigm shift to bridge these clinical divides. To best serve transplant recipients and their families, the field of pediatric transplantation needs to reintegrate palliative care.
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10. Effect of Pediatric Heart Transplant Waitlist Inactivation on Waitlist and Posttransplant Outcomes.
PMID:日期:2026-09-01Little is known about pediatric heart transplant candidates facing waitlist inactivation. We characterized them and assessed the impact of inactivation on waitlist and transplant outcomes. The Organ Procurement and Transplantation Network database was queried for pediatric heart-only transplant candidates. Characteristics, waitlist mortality, and 1-year posttransplant survival between inactivated and non-inactivated patients were compared. Predicted probability for the composite outcome of waitlist mortality or removal due to clinical deterioration over time was computed. Of 5202 patients, 1716 (33%) were inactivated, mostly due to temporary illness (58%). Reasons for inactivation varied by age but not diagnosis. Inactivated patients had longer waitlist duration (171 [77-391] vs. 62 [21-144], p < 0.001), more congenital heart disease (61.0% vs. 55.2%, p < 0.001), and were more often supported by ventricular assist device (47.9% vs. 32.9%, p < 0.001) and invasive ventilation at listing (19.9% vs. 13.6%, p < 0.001). Inactivated patients were less likely listed Status 1A (56.8% vs. 62.3%, p < 0.001) and less likely under intensive care at transplant (43.9% vs. 50.2%, p < 0.001). Inactivated patients had higher 1-year waitlist mortality and removal due to clinical deterioration (SHR 4.40 [3.72-5.20], p < 0.001), though this risk decreased with longer inactive time. One-year posttransplant survival was similar between groups. Waitlist inactivation was strongly associated with 1-year waitlist mortality and removal due to clinical deterioration. However, this risk decreased with longer inactive time and made no difference in short-term posttransplant survival. Thus, the prognostic implications of inactivation are dynamic and can inform future donor allocation policy development.