TY - JOUR
T1 - Issues in solid-organ transplantation in children
T2 - Translational research from bench to bedside
AU - Lipshultz, Steven E.
AU - Chandar, Jayanthi J.
AU - Rusconi, Paolo G.
AU - Fornoni, Alessia
AU - Abitbol, Carolyn L.
AU - Burke, George W.
AU - Zilleruelo, Gaston E.
AU - Pham, Si M.
AU - Perez, Elena E.
AU - Karnik, Ruchika
AU - Hunter, Juanita A.
AU - Dauphin, Danielle D.
AU - Wilkinson, James D.
PY - 2014
Y1 - 2014
N2 - In this review, we identify important challenges facing physicians responsible for renal and cardiac transplantation in children based on a review of the contemporary medical literature. Regarding pediatric renal transplantation, we discuss the challenge of antibody-mediated rejection, focusing on both acute and chronic antibody-mediated rejection. We review new diagnostic approaches to antibody-mediated rejection, such as panel-reactive antibodies, donor-specific cross-matching, antibody assays, risk assessment and diagnosis of antibody-mediated rejection, the pathology of antibody-mediated rejection, the issue of ABO incompatibility in renal transplantation, new therapies for antibody-mediated rejection, inhibiting of residual antibodies, the suppression or depletion of B-cells, genetic approaches to treating acute antibody-mediated rejection, and identifying future translational research directions in kidney transplantation in children. Regarding pediatric cardiac transplantation, we discuss the mechanisms of cardiac transplant rejection, including the role of endomyocardial biopsy in detecting graft rejection and the role of biomarkers in detecting cardiac graft rejection, including biomarkers of inflammation, cardiomyocyte injury, or stress. We review cardiac allograft vasculopathy. We also address the role of genetic analyses, including genome-wide association studies, gene expression profiling using entities such as AlloMap®, and adenosine triphosphate release as a measure of immune function using the Cylex® ImmuKnow™ cell function assay. Finally, we identify future translational research directions in heart transplantation in children.
AB - In this review, we identify important challenges facing physicians responsible for renal and cardiac transplantation in children based on a review of the contemporary medical literature. Regarding pediatric renal transplantation, we discuss the challenge of antibody-mediated rejection, focusing on both acute and chronic antibody-mediated rejection. We review new diagnostic approaches to antibody-mediated rejection, such as panel-reactive antibodies, donor-specific cross-matching, antibody assays, risk assessment and diagnosis of antibody-mediated rejection, the pathology of antibody-mediated rejection, the issue of ABO incompatibility in renal transplantation, new therapies for antibody-mediated rejection, inhibiting of residual antibodies, the suppression or depletion of B-cells, genetic approaches to treating acute antibody-mediated rejection, and identifying future translational research directions in kidney transplantation in children. Regarding pediatric cardiac transplantation, we discuss the mechanisms of cardiac transplant rejection, including the role of endomyocardial biopsy in detecting graft rejection and the role of biomarkers in detecting cardiac graft rejection, including biomarkers of inflammation, cardiomyocyte injury, or stress. We review cardiac allograft vasculopathy. We also address the role of genetic analyses, including genome-wide association studies, gene expression profiling using entities such as AlloMap®, and adenosine triphosphate release as a measure of immune function using the Cylex® ImmuKnow™ cell function assay. Finally, we identify future translational research directions in heart transplantation in children.
KW - Cardiac
KW - Child
KW - Heart transplantation
KW - Kidney transplantation
KW - Renal transplantation
KW - Translational medical research
KW - Transplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=84893119536&partnerID=8YFLogxK
U2 - 10.6061/clinics/2014(Sup01)11
DO - 10.6061/clinics/2014(Sup01)11
M3 - Review article
C2 - 24860861
AN - SCOPUS:84893119536
VL - 69
SP - 55
EP - 72
JO - Clinics
JF - Clinics
SN - 1807-5932
IS - SUPPL.1
ER -