ABSTRACT
The post-transplant lymphoproliferative disorders (PTLD) are a diverse group of potentially life-threatening conditions affecting organ transplant recipients. PTLD arises in the setting of an attenuated host immunologic system that is manipulated to allow a foreign graft but then fails to provide adequate immune surveillance of transformed malignant or premalignant lymphocytes. The diversity of biological behavior and clinical presentation makes for a challenging clinical situation for those involved in the care of children with PTLD occurring after solid-organ transplantation. This review details a large transplant center's multidisciplinary approach to monitoring for PTLD and systematic approach to intervention, which has been essential for early recognition and successful treatment.
Subject(s)
Lymphoproliferative Disorders , Organ Transplantation , Postoperative Complications , Child , Combined Modality Therapy , Humans , Lymphoproliferative Disorders/diagnosis , Lymphoproliferative Disorders/etiology , Lymphoproliferative Disorders/therapy , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/therapy , Risk Factors , Treatment OutcomeABSTRACT
Cerebral infarction is a common complication in sickle cell disease. Both overt and silent infarcts evident on neuroimaging have been described. In this article we overview the current knowledge of cerebral infarction in this patient population and discuss recent updates on the role of preventive intervention.
Subject(s)
Anemia, Sickle Cell/complications , Cerebral Infarction/etiology , Anemia, Sickle Cell/therapy , Cerebral Infarction/diagnosis , Cerebral Infarction/prevention & control , Child , Child, Preschool , Humans , Magnetic Resonance ImagingABSTRACT
The pulmonary complications of sickle cell disease are a major cause of morbidity and mortality in affected patients. The acute chest syndrome (ACS) is a leading cause of death in patients with sickle cell disease and has a multifactorial etiology. Hydroxyurea (HU), stem cell transplantation (SCT) and chronic transfusions are known to prevent the recurrence of ACS. Careful management of patients admitted for pain crises and surgery including use of incentive spirometry is critical in preventing this complication. Pulmonary hypertension is well known to be associated with sickle cell disease and patients with pulmonary hypertension have increased mortality. Asthma is also commonly seen in patients with sickle cell disease and is associated with a more complicated course. Chronic lung disease develops in a significant proportion of patients with sickle cell disease.
