ABSTRACT
Immunosuppressive therapy in pediatrics continues to evolve. Over the past decade, newer immunosuppressive agents have been introduced into adult and pediatric transplant patients with the goal of improving patient and allograft survival. Unfortunately, large-scale randomized clinical trials are not commonly performed in children. The purpose of this review is to discuss the newer immunosuppressive agents available for induction therapy, maintenance immunosuppression, and the treatment of rejection.
Subject(s)
Adult , Child , Humans , Graft Rejection/drug therapy , Immunosuppressive Agents/therapeutic use , Organ Transplantation , Immunosuppression Therapy/methods , Immunosuppressive Agents/pharmacologyABSTRACT
Objective To study on the significance of accompany relatives of children with access to pediatric transplantation ward on clinical treatment and nursing.Methods 37 children undergoing autologous peripheral blood stem cell transplantation (APBST) were collected from January 2007 to April 2010.All cases were divided into the no tending group(7 cases)and the tending group (30 cases).The accompany relatives of the tending group accepted standard training before entering the ward.The compliance with basic nursing,acute side-effect and hemopoiesis rebuild period of marrow during APBST in two groups were compared.Results The compliance with basic nursing of the no tending group was only 28.6％,but was 73.3％ in the tending group.According to Bearman standard,the acute side-effect of the no tending group:1 case of grade Ⅳ,1 case of grade Ⅲ,4 cases of grade Ⅱ,1case of grade Ⅰ; in the tending group:1 case of grade Ⅳ,1 case of grade Ⅲ,6 cases of grade Ⅱ,22 case of grade Ⅰ.The marrow-reconstitution took place in 36 children.The most long time was 41 days in the no tending group,the average time was (28.14+7.98)days.The time took for marrow-reconstitution was 22 days in the tending group,the average time was ( 14.61+2.33)days.Conclusions It is safe and feasible for accompany relatives of children to participate in nursing during transplantation.Relatives accompany is beneficial for psychology adaptability,nursing compliance and success of APBST.
ABSTRACT
A prospective analysis of active Human Cytomegalovirus infection (HCMV) was conducted on 33 pediatric renal or hematopoietic stem cell post-transplant patients. The HCMV-DNA positive samples were evaluated for the prevalence of different gB subtypes and their subsequent correlation with clinical signs. The surveillance of HCMV active infection was based on the monitoring of antigenemia (AGM) and on a nested polymerase chain reaction (N-PCR) for the detection of HCMV in the patients studied. Using restriction analysis of the gB gene sequence by PCR-RFLP (Restriction Fragment Length Polymorphism), different HCMV strains could be detected and classified in at least four HCMV genotypes. Thirty-three pediatric recipients of renal or bone marrow transplantation were monitored. Twenty out of thirty-three (60.6%) patients demonstrated active HCMV infection. gB1 and gB2 genotypes were more frequent in this population. In this study, we observed that gB2 had correlation with reactivation of HCMV infection and that patients with mixture of genotypes did not show any symptoms of HCMV disease. Future studies has been made to confirm this.
ABSTRACT
A prospective analysis of active Human Cytomegalovirus infection (HCMV) was conducted on 33 pediatric renal or hematopoietic stem cell post-transplant patients. The HCMV-DNA positive samples were evaluated for the prevalence of different gB subtypes and their subsequent correlation with clinical signs. The surveillance of HCMV active infection was based on the monitoring of antigenemia (AGM) and on a nested polymerase chain reaction (N-PCR) for the detection of HCMV in the patients studied. Using restriction analysis of the gB gene sequence by PCR-RFLP (Restriction Fragment Length Polymorphism), different HCMV strains could be detected and classified in at least four HCMV genotypes. Thirty-three pediatric recipients of renal or bone marrow transplantation were monitored. Twenty out of thirty-three (60.6 percent) patients demonstrated active HCMV infection. gB1 and gB2 genotypes were more frequent in this population. In this study, we observed that gB2 had correlation with reactivation of HCMV infection and that patients with mixture of genotypes did not show any symptoms of HCMV disease. Future studies has been made to confirm this.