Kidney failure can complicate long-term outcomes in children receiving solid-organ transplants

CHOP-led study of national records suggests need for screening, preventive measures following pediatric transplants

2013-10-14

(Press-News.org) Children who undergo transplants of solid organs have a high risk of developing advanced kidney disease, according to a new national study. Among these children, the highest risk is in those receiving lung or intestinal transplants, followed by heart and then liver transplants. The researchers say their findings reinforce the importance of continued screening of kidney function in pediatric transplant recipients.

"We found that the risk patterns for kidney disease are different among patients who receive solid-organ transplants as children, compared to adult transplant recipients," said pediatric nephrologist Rebecca L. Ruebner, M.D., of The Children's Hospital of Philadelphia. "Because chronic and end-stage kidney disease carry high burdens of mortality and serious illness, it is important to take preventive measures to slow or prevent disease progression."

Ruebner is the first author of a study published online today in Pediatrics. The senior author is Susan L. Furth, M.D., Ph.D., chief of Nephrology at Children's Hospital.

Using data from the Scientific Registry of Transplant Recipients, the study team analyzed records of 16,600 pediatric patients who received solid-organ transplants (liver, heart, lung, intestine, and heart-lung) from 1990 to 2010 across the U.S. This was the first pediatric study to compare the relative incidence of end-stage kidney disease (ESKD) by type of organ transplant. It was also the first analysis to identify the risk of advanced kidney disease among pediatric solid-organ recipients over a 20-year period.

In this two-decade national cohort, the researchers found that ESKD occurred in 3 percent of pediatric solid-organ recipients, with the highest risk of ESKD among those who received lung transplants or intestinal transplants. Patients who received liver transplants as children had the lowest rate of ESKD.

In contrast, adult liver transplant recipients are known to have the highest risk of ESKD and adult lung transplant recipients have lower risks of ESKD. For both children and adults, intestinal transplantation carries higher risks of ESKD.

"Although the overall incidence of end-stage kidney disease was only 3 percent, the broader burden of chronic kidney disease is much higher in this population of pediatric transplant recipients," said Ruebner. "Children with chronic kidney disease experience a steady decline in kidney function, so we recommend that pediatric healthcare providers carefully follow post-transplant patients to detect any early signs of kidney problems, with early referral, if necessary, to a pediatric nephrologist."

### The National Institutes of Health supported this research (grants DK078737, DK066174, DK078688-01, DK093556). Other support came from the National Kidney Foundation/Amgen KDOQI Research Fellowship and the Nephcure Foundation--American Society of Nephrology Research Grant.

In addition to Ruebner and Furth, other co-authors were Michelle R. Denburg, M.D., MSCE, of Children's Hospital; and Peter P. Reese, M.D., MSCE, and Peter L. Abt, M.D., both of the Perelman School of Medicine at the University of Pennsylvania.

"End-Stage Kidney Disease after Pediatric Non-Renal Solid Organ Transplantation," Pediatrics, published online Oct. 14, 2013, to appear in Nov. 2013 print issue.

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program receives the highest amount of National Institutes of Health funding among all U.S. children's hospitals. In addition, its unique family-centered care and public service programs have brought the 527-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.

ELSE PRESS RELEASES FROM THIS DATE:

Football-shaped particles bolster the body's defense against cancer

2013-10-14

Researchers at Johns Hopkins have succeeded in making flattened, football-shaped artificial particles that impersonate immune cells. These football-shaped particles seem to be better than the typical basketball-shaped particles at teaching immune cells to recognize and destroy cancer cells in mice. "The shape of the particles really seems to matter because the stretched, ellipsoidal particles we made performed much better than spherical ones in activating the immune system and reducing the animals' tumors," according to Jordan Green, Ph.D., assistant professor of biomedical ...

Choreographed origami

2013-10-14

An important step in building ribosomes – the cell's protein factories – is like a strictly choreographed dance, scientists at the European Molecular Biology Laboratory (EMBL) in Heidelberg, Germany, have discovered. To build these factories, other 'machines' inside the cell have to produce specific RNA molecules and fold them into the right shape, then combine the folded RNA with proteins to form a working ribosome. Like a budding origami artist pencilling in the folds, the cell uses tags called methyl groups to help mark where and how an RNA molecule should be folded. ...

Psychological interventions halve deaths and CV events in heart disease patients

2013-10-12

This news release is available in Spanish. Madrid, Spain – 13 October 2013: Psychological interventions halve deaths and cardiovascular events in heart disease patients, according to research from Athens, Greece, presented at the Acute Cardiac Care Congress 2013. The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC). It takes place 12-14 October in Madrid, Spain. Dr Zoi Aggelopoulou, a nurse and one of the study authors, said: "The nurses on our coronary ...

Heart attack patients return to work later and retire earlier if treatment is delayed

2013-10-12

This news release is available in Spanish. Madrid, Spain – 12 October 2013: System delay in treating patients with ST-elevation myocardial infarction (STEMI) postpones their return to work and increases early retirement, according to research presented at the Acute Cardiac Care Congress 2013 by Kristina Laut, PhD student from Aarhus, Denmark. The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute Cardiovascular Care Association (ACCA) of the European Society of Cardiology (ESC) and is held 12-14 October in Madrid, Spain. Ms Laut said: "System ...

CNIO researchers discover a new regulator of drug detoxification

2013-10-12

Drug abuse and alcohol are some of the most frequent causes of liver damage, particularly in developed countries. Such kind of liver damage can cause irreversible liver failure and even cancer. Researchers from the Spanish National Cancer Research Centre (CNIO) have discovered an important new protective role of the Fra-1 protein, which neutralizes the damage caused by agents, such as the analgesic drug acetaminophen (Paracetamol). This is the first study to reveal a function of Fra-1 in protecting this important organ. The study is published today in the journal Hepatology. The ...

Video captions improve comprehension, professor finds

2013-10-12

A simple change -- switching on captions -- can make a big difference when students watch educational videos, an SF State professor has discovered. Robert Keith Collins, an assistant professor of American Indian studies, found that students' test scores and comprehension improved dramatically when captions were used while watching videos. The tool is often utilized for students with learning disabilities, but Collins says his results show captions can be beneficial to all students. Collins developed the idea while he was a member of a faculty learning committee focused ...

American Chemical Society: Federal shutdown undermines US innovation and critical services

2013-10-12

American Chemical Society President Marinda Li Wu, Ph.D., said the budget impasse is effectively choking America's science innovation pipeline, strangling new discoveries, future economic growth and job creation. As a result of the shutdown, the National Science Foundation (NSF) will issue no new grants or cooperative agreements for innovative scientific research, and no continuing grant increments for existing projects will be provided, effectively suspending or completely halting critical research efforts. NSF recalled scientists from the U.S. Antarctic Research Stations ...

Immune system discovery could lead to EBV vaccine to prevent mono, some cancers

2013-10-12

Development of a vaccine against Epstein-Barr virus (EBV) has taken a step forward with the Canadian discovery of how EBV infection evades detection by the immune system. EBV causes infectious mononucleosis and cancers such as Hodgkin's lymphoma and nasopharyngeal carcinoma, which is the most common cancer in China, as well as opportunistic cancers in people with weakened immune systems. A member of the herpes virus family that remains in the body for life, the virus infects epithelial cells in the throat and immune cells called B cells. The researchers discovered ...

Scientists identify protein linking exercise to brain health

2013-10-12

BOSTON—A protein that is increased by endurance exercise has been isolated and given to non-exercising mice, in which it turned on genes that promote brain health and encourage the growth of new nerves involved in learning and memory, report scientists from Dana-Farber Cancer Institute and Harvard Medical School. The findings, reported in the journal Cell Metabolism, help explain the well-known capacity of endurance exercise to improve cognitive function, particularly in older people. If the protein can be made in a stable form and developed into a drug, it might lead ...

Outside influence: Genes outside nucleus have disproportionate effect

2013-10-12

New research from the University of California, Davis, shows that the tiny proportion of a cell's DNA that is located outside the cell nucleus has a disproportionately large effect on a cell's metabolism. The work, with the model plant Arabidopsis, may have implications for future treatments for inherited diseases in humans. Plant and animal cells carry most of their genes on chromosomes in the nucleus, separated from the rest of the cell. However, they also contain a small number of genes in organelles that lie outside the nucleus. These are the mitochondria, which generate ...

Kidney failure can complicate long-term outcomes in children receiving solid-organ transplants

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: