Infections among pediatric transplant candidates: An approach to decision-making.


Journal

Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574

Informations de publication

Date de publication:
05 2019
Historique:
received: 11 07 2018
revised: 14 12 2018
accepted: 21 12 2018
pubmed: 7 3 2019
medline: 26 3 2020
entrez: 7 3 2019
Statut: ppublish

Résumé

The presence of infections in the immediate pretransplant period poses challenges in decision-making. Delaying transplantation because of these infections may be required, but is associated with a risk to the potential recipient. The aim of this project was to develop a structured framework based on expert opinion to guide decision-making regarding the safety of transplantation for candidates with infection immediately before transplant, and to show how this framework can be applied to clinical scenarios. Categories were created as follows: Category A: no delay; Category B: brief delay (≤1 week); Category C: intermediate delay (>1 week); and Category D: more prolonged or indefinite delay. A survey containing 59 clinical scenarios was sent to members of the IPTA ID CARE committee. Answers were reviewed, and the level of agreement was characterized as follows: Level 1: ≥75% agreement; Level 2:51%-74% agreement; and Level 3: ≤50% agreement. 95% CIs were calculated for the mean overall agreement across 59 scenarios. Among the panel, the agreement level ranged from 33% to 92% with the mean overall agreement across the 59 scenarios being 61%. For 7/59 scenarios, the lower bound of 95% CI was greater than 50%, indicating a difference at the 5% level of significance between the observed proportion and the chance level of 0.5. The document provides expert opinion regarding the need to delay transplantation in the setting of different infections. The most important points in the decision to proceed to SOT included the urgency of transplantation and the severity of infection.

Identifiants

pubmed: 30838753
doi: 10.1111/petr.13375
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13375

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Auteurs

Arnaud G L'Huillier (AG)

The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Geneva University Hospitals, Geneva, Switzerland.

Michael Green (M)

UPMC Children's Hospital of Pittsburgh, Pennsylvania.

Lara Danziger-Isakov (L)

Cincinnati Children's Hospital and the University of Cincinnati, Cincinnati, Ohio.

Abanti Chaudhuri (A)

Stanford Children's Hospital, Stanford, California.

Britta Höcker (B)

University Children's Hospital of Heidelberg, Heidelberg, Germany.

Dimitri Van der Linden (D)

Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Liz Goddard (L)

Red Cross Children's Hospital, Cape Town, South Africa.

Monica I Ardura (MI)

Nationwide Children's Hospital, Columbus, Ohio.

Derek Stephens (D)

The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Anita Verma (A)

King's College Hospital, London, UK.

Helen M Evans (HM)

Starship Child Health, Auckland, New Zealand.

Mignon McCulloch (M)

Red Cross Children's Hospital, Cape Town, South Africa.

Marian G Michaels (MG)

UPMC Children's Hospital of Pittsburgh, Pennsylvania.

Klara M Posfay-Barbe (KM)

Geneva University Hospitals, Geneva, Switzerland.

Upton D Allen (UD)

The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH