National Healthcare Quality and Disparities Report
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Topics
- Access to Care (4)
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- (-) Children/Adolescents (28)
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- Policy (1)
- Practice Patterns (1)
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- Racial and Ethnic Minorities (1)
- Registries (2)
- Shared Decision Making (1)
- Sickle Cell Disease (1)
- Surgery (6)
- (-) Transplantation (28)
- Vaccination (7)
- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 28 Research Studies DisplayedMcAteer J, Kalluri DD, Abedon RR
Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients.
This study examined COVID-19 m-RNA vaccine antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among adolescent solid organ transplant recipients (aSOTRs). The 34 participants were surveyed after they received the third dose of the vaccine and were sampled at 1-, 3-, and 6-months post-D3. All had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 29% having decreased antibody levels at 6 months compared to 3 months and 7% reporting increased titers at 6 months. The remaining 18 had unchanged antibody titers compared to 3-month post-D3 levels. A total of 12% reported breakthrough infection within 6 months and 9% reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine.
AHRQ-funded; HS026510.
Citation: McAteer J, Kalluri DD, Abedon RR .
Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients.
Pediatr Transplant 2024 Feb; 28(1):e14671. doi: 10.1111/petr.14671.
Keywords: COVID-19, Vaccination, Transplantation, Children/Adolescents
Feldman AG, Beaty BL, Ferrolino Ja
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
This study’s objective was to determine the safety and immunogenicity of live vaccines in pediatric liver and kidney transplant recipients. This cohort study included 281 children, of which 270 had received a liver transplant, 9 a kidney transplant, and 2 were liver-kidney transplant recipients. None of the children included had completed their primary measles-mumps-rubella (MMR) and varicella-zoster virus (VZV) vaccine series and/or had displayed nonprotective serum antibody levels at enrollment between January 1, 2002, and February 28, 2023. Safety data was collected after these transplant recipients had received 1 to 3 doses or MMR vaccine and/or 1 to 3 doses of VZV vaccine. The median time from transplant to enrollment was 6.3 years, with the median age at first posttransplant vaccine 8.9 years. The majority of children developed protective antibodies following vaccination (107 of 149 varicella, 130 of 152 measles, 100 of 120 mumps, and 124 of 125 rubella). One year post vaccination, the majority of children who initially mounted protective antibodies maintained this protection (34 of 44 varicella, 45 of 49 measles, 35 of 42 mumps, 51 of 54 rubella). Five children developed varicella, all of which resolved within 1 week, and there were no cases of measles or rubella and no episodes or graft rejection within 1 month of vaccination. There was also no association between antibody response and immunosuppression level at the time of vaccination.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty BL, Ferrolino Ja .
Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients.
JAMA Netw Open 2023 Oct; 6(10):e2337602. doi: 10.1001/jamanetworkopen.2023.37602..
Keywords: Children/Adolescents, Vaccination, Transplantation
Feldman AG, Beaty B, Everitt M
Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.
This study’s objective was to assess COVID-19 policies at US pediatric solid organ transplant centers. A 79-item survey was created and emailed between March and April 2022 to 200 UNOS Medical Directors detailing center COVID-19 vaccine policies for transplant candidates and living donors and use of grafts from COVID-19-positive deceased donors. The response rate was 77%. For children aged 5-15 years, 23% of centers have a COVID-19 vaccine mandate, 27% anticipate implementing a future mandate, and 47% have not considered or do not anticipate implementing a mandate. For children ≥16 years, 32% of centers have a COVID-19 vaccine mandate, 25% anticipate implementing a future mandate, and 40% have not considered or do not anticipate implementing a mandate. The top two reasons provided for not implementing a COVID-19 vaccine mandate were concerns about penalizing a child for their parent's decision and worsening inequities in transplant. Almost a third of 85 (27/85) kidney and liver living donor centers require vaccinations of donors. Twenty percent of centers accept organs from COVID-19-positive deceased donors.
AHRQ-funded; HS026510.
Citation: Feldman AG, Beaty B, Everitt M .
Survey of pediatric transplant center practices regarding COVID-19 vaccine mandates for transplant candidates and living donors and use of COVID-19-positive deceased organs.
Pediatr Transplant 2023 Sep; 27(6):e14513. doi: 10.1111/petr.14513..
Keywords: COVID-19, Children/Adolescents, Transplantation
Qin CX, Auerbach SR, Charnaya O
Antibody response to three SARS-CoV-2 mRNA vaccines in adolescent solid organ transplant recipients.
The purpose of this observational cohort study was to assess whether a third SARS-CoV-2 vaccine would improve immunogenicity in adolescent solid organ transplant recipients (SOTRs), and to report the antibody response and safety of a third mRNA vaccine dose (D3) in adolescent SOTRs. Forty-two participants received three BNT162b2 doses and one received three mRNA-1273 doses. Participants were 6-13 years from transplant (median 10 [IQR]), and heart transplant was the most common procedure, in 41.9% of the participants. 9.3% of participants reported pre-D1 SARS-CoV-2 infections and 9.3% reported breakthrough infections. The study found that 88.4% of adolescent SOTRs had positive antibody responses 1 month post-D3, an increase from 63–73% post-D2. 54.5% of participants with prior negative responses seroconverted and 100% with positive responses increased or remained at maximum titer. Titers remained stable 3 months post-D3. There were no vaccine-related adverse events and four breakthrough infections. The researchers concluded that although this was a convenience sample, the results suggest there is an antibody response benefit to a third SARS-CoV-2 vaccine in adolescent SOTRs.
AHRQ-funded; HS026510.
Citation: Qin CX, Auerbach SR, Charnaya O .
Antibody response to three SARS-CoV-2 mRNA vaccines in adolescent solid organ transplant recipients.
Am J Transplant 2022 Oct;22(10):2481-83. doi: 10.1111/ajt.17085..
Keywords: Children/Adolescents, COVID-19, Vaccination, Transplantation
Bowring MG, Massie AB, Schwarz KB
Survival benefit of split-liver transplantation for pediatric and adult candidates.
The patient and graft survival rates for split -liver transplantations (SLTs) among pediatric and adult recipients are similar to those of whole-liver transplantations (WLTs), yet SLTs are rarely used. The purpose of the study was to compare the survival benefit of accepting an offer of a splittable graft vs waiting for a subsequent offer. The researchers utilized data from the 2010 to 2018 Scientific Registry of Transplant Recipients (SRTR) on 1814 adult and 928 pediatric liver transplantation candidates ever offered a splittable graft, and compared the eventual mortality between patients who accepted vs declined an offer for an SLT. The study discovered that among adult candidates, acceptance of an SLT offer was associated with a 43% reduction in mortality, and within 1 year of declining an offer 39.3% received a WLT, and 7.9% died. In pediatric cases with a weight of less than or equal to 7 kilograms, acceptance of a split liver offer versus declining the offer was associated with a 63% reduction in mortality, and within 1 year of declining 45.8% received a WLT and 6.4% died. In the group of pediatric cases with weight greater than 7 kilograms there was no significant difference between acceptance of an SLT offer and decline. The study concluded that accepting an offer for SLT could significantly improve survival for adults and small children on the liver transplant waiting list.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Schwarz KB .
Survival benefit of split-liver transplantation for pediatric and adult candidates.
Liver Transpl 2022 Jun;28(6):969-82. doi: 10.1002/lt.26393..
Keywords: Children/Adolescents, Transplantation
Kemme S, Yoeli D, Sundaram SS
Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
The purpose of the study was to explore and understand the impact of the COVID-19 pandemic on nationwide pediatric liver transplants. The researchers compared data for transplant waiting list additions, removals, and liver transplants during pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020). The study results showed a 38% decrease in liver transplantations during early COVID-19, recovering to pre-pandemic rates during late COVID-19. White children had a 30% decrease in overall liver transplantation, while non-White children had a 44% decrease in overall liver transplantation. Additions to the waiting list decreased 25% during COVID-19, with Black transplant candidates the most affected, and children spent longer on the waiting list during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days). The study concluded that the COVID-19 pandemic decreased access to pediatric liver transplants, especially during early COVID-19. The researchers discussed that although the rate of pediatric liver transplants has resumed to pre-COVID-19 levels, racial disparities must be addressed.
AHRQ-funded; HS026510.
Citation: Kemme S, Yoeli D, Sundaram SS .
Decreased access to pediatric liver transplantation during the COVID-19 pandemic.
Pediatr Transplant 2022 Mar;26(2):e14162. doi: 10.1111/petr.14162..
Keywords: Children/Adolescents, COVID-19, Transplantation, Access to Care, Disparities
Qin CX, Auerbach SR, Charnaya O
Antibody response to 2-dose SARS-CoV-2 mRNA vaccination in pediatric solid organ transplant recipients.
While many adult solid organ transplant recipients (SOTRs) have impaired antibody response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, pediatric SOTRs’ response has not been assessed. In this article, the researchers reported the immunogenicity and safety of BNT162b2 mRNA vaccination in pediatric SOTRs.
AHRQ-funded; HS026510.
Citation: Qin CX, Auerbach SR, Charnaya O .
Antibody response to 2-dose SARS-CoV-2 mRNA vaccination in pediatric solid organ transplant recipients.
Am J Transplant 2022 Feb;22(2):669-72. doi: 10.1111/ajt.16841..
Keywords: Children/Adolescents, Vaccination, COVID-19, Transplantation
Schulz GL, Kelly KP, Holtmann M
Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease.
Patients with sickle cell disease (SCD) face unpredictable disease, with stem cell transplant being a curative treatment option with risks. The aim of this study was to describe the level and source of decisional conflict in families of children/adolescents with SCD facing a transplant decision. The investigators concluded that varying levels and sources of decisional conflict existed in pediatric patients with SCD and their families considering transplant.
AHRQ-funded; HS022140.
Citation: Schulz GL, Kelly KP, Holtmann M .
Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease.
Patient Educ Couns 2021 May;104(5):1086-93. doi: 10.1016/j.pec.2020.10.011..
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Transplantation, Shared Decision Making
Feldman AG, Marsh R, Kempe A
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
Investigators described the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pre-transplant immunization rates. Five central themes emerged: gaps in knowledge about timing and safety of pre-transplant immunizations; lack of communication, coordination, and follow-up between team members; lack of centralized immunization records; subspecialty clinics functioning as the medical home for transplant candidates, but not able to provide all needed immunizations; and differences between organ type in prioritization and completion of pre-transplant immunization. The authors recommended new tools to overcome these barriers and to increase immunization rates in transplant candidates.
AHRQ-funded; HS026510.
Citation: Feldman AG, Marsh R, Kempe A .
Barriers to pretransplant immunization: a qualitative interview study of pediatric solid organ transplant stakeholders.
J Pediatr 2020 Dec;227:60-68. doi: 10.1016/j.jpeds.2020.07.038..
Keywords: Children/Adolescents, Transplantation, Surgery, Healthcare Delivery, Healthcare Utilization
Kemme S, Sundaram SS, Curtis DJ
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
The goal of this study was to assess current post-transplant live vaccine practices at individual pediatric liver transplant centers following the updated AST guidelines. Using email surveys with a 93% response rate, findings showed that only 29% of centers offered live vaccines post-transplant, with each center using different eligibility criteria for live vaccines. The main reasons for a center not offering post-transplant live vaccines were safety concerns and inability to reach group consensus.
AHRQ-funded; HS026510.
Citation: Kemme S, Sundaram SS, Curtis DJ .
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
Pediatr Transplant 2020 Aug 26:e13804. doi: 10.1111/petr.13804..
Keywords: Children/Adolescents, Transplantation, Surgery, Vaccination, Practice Patterns
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Covarrubias K, Luo X, Massie A
Determinants of length of stay after pediatric liver transplantation.
In this study, the investigators sought to identify factors that were associated with LOS following pediatric (<18 years) liver transplantation in order to provide personalized counseling and discharge planning for recipients and their families. They concluded that while center-level practices accounted for substantial variation in LOS, consideration of donor and recipient factors could help clinicians provide more personalized counseling for families of pediatric liver transplant candidates.
AHRQ-funded; HS023876.
Citation: Covarrubias K, Luo X, Massie A .
Determinants of length of stay after pediatric liver transplantation.
Pediatr Transplant 2020 Jun;24(4):e13702. doi: 10.1111/petr.13702..
Keywords: Children/Adolescents, Transplantation
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Feldman AG, Curtis DJ, Moore SL
Under-immunization of pediatric transplant recipients: a call to action for the pediatric community.
This article is a call to action for pediatric solid organ transplant recipients to receive their recommended immunizations. Vaccine-preventable infections (VIPs) occur in 1 in 6 pediatric transplant recipients and these hospitalizations result in significant morbidity, mortality, graft injury, and cost. There has been an increase in the overall population in non-medical vaccine exemptions, which reduces herd immunity and creates greater risk for patients undergoing or already having received transplants.
AHRQ-funded; HS026510.
Citation: Feldman AG, Curtis DJ, Moore SL .
Under-immunization of pediatric transplant recipients: a call to action for the pediatric community.
Pediatr Res 2020 Jan;87(2):277-81. doi: 10.1038/s41390-019-0507-4..
Keywords: Children/Adolescents, Transplantation, Vaccination, Adverse Events, Patient Safety
Feldman AG, Sundaram SS, Beaty BL
Immunization status at the time of liver transplant in children and adolescents.
In this research letter, the authors quantified the percentage of patients at Society of Pediatric Liver Transplantation centers who were up to date for their age on immunizations at the time of transplant, and determined whether demographic and clinical factors were associated with immunization status at the time of transplant. They concluded that further research is needed to understand barriers to immunization in the pediatric transplant population and called for novel tools that provide pretransplant vaccine education and enhance communication between primary care and subspecialty clinicians.
AHRQ-funded; HS026510.
Citation: Feldman AG, Sundaram SS, Beaty BL .
Immunization status at the time of liver transplant in children and adolescents.
JAMA 2019 Nov 12;322(18):1822-24. doi: 10.1001/jama.2019.14386..
Keywords: Transplantation, Children/Adolescents, Vaccination, Surgery
Luo X, Mogul DB, Massie AB
Predicting chance of liver transplantation for pediatric wait-list candidates.
The authors sought to predict the chance of receiving a deceased donor liver transplant (DDLT) for pediatric patients. Their model accurately predicted chance of transplant and was able to predict DDLT at specific follow-up times. They conclude that their model can serve as the basis for an online tool that would provide useful information for pediatric wait-list candidates.
AHRQ-funded; HS023876.
Citation: Luo X, Mogul DB, Massie AB .
Predicting chance of liver transplantation for pediatric wait-list candidates.
Pediatr Transplant 2019 Nov;23(7):e13542. doi: 10.1111/petr.13542..
Keywords: Children/Adolescents, Transplantation, Healthcare Delivery, Access to Care
Mogul DB, Fredericks EM, Brady TM
Digital wings: innovations in transition readiness for adolescent and young adult transplant recipients.
This article reports on two multi-stakeholder symposia organized by The Johns Hopkins University School of Medicine on February 2, 2018, and January 11, 2019, to address the problem of high graft failure in adolescent and young adult solid organ transplant recipients. Additionally, data collected from recipients demonstrated a substantial gap in how this population uses technologies for health-related activities, alongside an increased interest in an app to help them manage their transplant.
AHRQ-funded; HS023876.
Citation: Mogul DB, Fredericks EM, Brady TM .
Digital wings: innovations in transition readiness for adolescent and young adult transplant recipients.
Transplantation 2019 Oct;103(10):1970-74. doi: 10.1097/tp.0000000000002749..
Keywords: Transplantation, Children/Adolescents, Young Adults, Surgery, Patient-Centered Outcomes Research, Evidence-Based Practice
Mogul DB, Lee J, Purnell TS
Barriers to access in pediatric living-donor liver transplantation.
This study examined knowledge and attitudes about living donor liver transplantation (LDLT) among patients/caregivers for children awaiting or having received a liver transplant. LDLT is only used for 10% of transplant recipients, but has a much better outcome. A survey was conducted among 217 respondents. While 97% of respondents knew an individual could donate a portion of their kidney, only 72% knew evaluation steps, and 69% knew the donor surgery was covered by the recipient’s insurance. Individuals receiving public insurance and without a college degree were less likely to know someone who had been a living donor. This gap in knowledge can create barriers to increasing LDLT for children.
AHRQ-funded; HS023876; HS024600.
Citation: Mogul DB, Lee J, Purnell TS .
Barriers to access in pediatric living-donor liver transplantation.
Pediatr Transplant 2019 Sep;23(6):e13513. doi: 10.1111/petr.13513..
Keywords: Children/Adolescents, Access to Care, Transplantation
Yanik MV, Seifert ME MV, Seifert ME, Locke JE
CYP3A5 genotype affects time to therapeutic tacrolimus level in pediatric kidney transplant recipients.
Optimal management of immunosuppression in kidney transplantation requires a delicate balance of efficacy and toxicity. Tacrolimus (TAC) dose requirements are significantly impacted by genetic variation in CYP3A5 polymorphisms, however the impact that genotype has on clinical outcomes in the pediatric kidney transplant population remains unclear. In this study, the investigators evaluated a retrospective cohort of 98 pediatric kidney transplant recipients. In this paper, they report on their findings.
AHRQ-funded; HS013852.
Citation: Yanik MV, Seifert ME MV, Seifert ME, Locke JE .
CYP3A5 genotype affects time to therapeutic tacrolimus level in pediatric kidney transplant recipients.
Pediatr Transplant 2019 Aug;23(5):e13494. doi: 10.1111/petr.13494..
Keywords: Children/Adolescents, Transplantation, Kidney Disease and Health, Genetics
Fauer AJ, Hoodin F, Lalonde E
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients.
The authors of this article developed BMT Roadmap, a health information technology application on a tablet, to address caregivers' unmet needs with patient-specific information from the electronic health record. They conducted a preliminary feasibility study of BMT Roadmap in caregivers of adult and pediatric hematopoietic stem cell transplantation (HSCT) patients and registered the study on ClinicalTrials.gov. They found that BMT Roadmap was a feasible intervention to implement in HSCT caregivers, associated with increased activation and decreased burden; quality of life, however, was lowered across hospitalization. The authors conclude that their findings support the need for further development of caregiver-specific self-directed resources and provision for both inpatient and outpatient across the HSCT trajectory.
AHRQ-funded; HS023613.
Citation: Fauer AJ, Hoodin F, Lalonde E .
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients.
Support Care Cancer 2019 Jun;27(6):2103-12. doi: 10.1007/s00520-018-4450-4..
Keywords: Cancer, Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Life, Transplantation
Perito ER, Mogul DB, VanDerwerken D
The impact of increased allocation priority for children awaiting liver transplant: a Liver Simulated Allocation Model (LSAM) analysis.
This study examined the impact of prioritizing infants, children, adolescents, and the sickest adults (designated Status 1) for deceased donor livers. They compared outcomes for two “SharePeds” allocation schema to the allocation plan approved by the Organ Procurement and Transplant Network (OPTN) in December 2017. Both schemas would decrease waitlist deaths for infants, children, and Status 1 adults and increase access to all donors younger than 35 years.
AHRQ-funded; HS023876.
Citation: Perito ER, Mogul DB, VanDerwerken D .
The impact of increased allocation priority for children awaiting liver transplant: a Liver Simulated Allocation Model (LSAM) analysis.
J Pediatr Gastroenterol Nutr 2019 Apr;68(4):472-79. doi: 10.1097/mpg.0000000000002287.
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Keywords: Children/Adolescents, Transplantation, Policy
Mogul DB, Luo X, Garonzik-Wang J
Expansion of the liver donor supply through greater use of split-liver transplantation: identifying optimal recipients.
While the outcomes of split liver transplantation (SLT) and whole liver transplantation (WLT) are similar among pediatric recipients, the authors hypothesize that the relationship between graft type and outcomes may vary by patient, donor, or surgical characteristics. The study evaluated graft survival among transplant recipients using data from the Scientific Registry of Transplant Recipients to identify similar conditions for risk of graft loss between SLT and WLT. Characteristics associated with graft loss include: donor age, recipient weight, acute hepatic necrosis, autoimmune diseases, tumors, insurance type, and cold ischemia time.
AHRQ-funded; HS023876.
Citation: Mogul DB, Luo X, Garonzik-Wang J .
Expansion of the liver donor supply through greater use of split-liver transplantation: identifying optimal recipients.
Liver Transpl 2019 Jan;25(1):119-27. doi: 10.1002/lt.25340..
Keywords: Children/Adolescents, Patient-Centered Outcomes Research, Transplantation
Kelly MS, Spees L, Vinesett R
Utility of autopsy among pediatric allogeneic hematopoietic stem cell transplant recipients: one last chance to learn?
Researchers conducted a retrospective cohort study of children undergoing allogeneic hematopoietic stem cell transplant (HSCT) at Duke University who died of any cause in 1995 and 2016. They found no associations between autopsy performance and patient age, sex, HSCT indication, or HSCT donor. Additionally, the proportion of autopsies with an unexpected diagnosis did not change during the study period. The researchers conclude that the utility of autopsy in this patient population remains high despite a reduction in the identification of unexpected infections.
AHRQ-funded; HS000032.
Citation: Kelly MS, Spees L, Vinesett R .
Utility of autopsy among pediatric allogeneic hematopoietic stem cell transplant recipients: one last chance to learn?
Biol Blood Marrow Transplant 2018 Sep;24(9):1861-65. doi: 10.1016/j.bbmt.2018.05.030..
Keywords: Children/Adolescents, Transplantation
Mogul DB, Luo X, Bowring MG
Fifteen-year trends in pediatric liver transplants: split, whole deceased, and living donor grafts.
This study evaluated changes in patient and graft survival for pediatric liver transplant recipients since 2002, and to determine if these outcomes vary by graft type (whole liver transplant, split liver transplant [SLT], and living donor liver transplant [LDLT]). It concluded that in recent years, outcomes after the use of technical variant grafts are comparable with whole grafts, and may be superior for LDLT.
AHRQ-funded; HS023876.
Citation: Mogul DB, Luo X, Bowring MG .
Fifteen-year trends in pediatric liver transplants: split, whole deceased, and living donor grafts.
J Pediatr 2018 May;196:148-53.e2. doi: 10.1016/j.jpeds.2017.11.015.
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Keywords: Children/Adolescents, Patient-Centered Outcomes Research, Children/Adolescents, Transplantation
Mogul DB, Luo X, Chow EK
Impact of race and ethnicity on outcomes for children waitlisted for pediatric liver transplantation.
This study sought to determine whether outcomes on the waitlist (ie, mortality, deceased donor liver transplantation [DDLT], and living-donor liver transplantation [LDLT]) varied by race/ethnicity. It concluded that, compared to Caucasian children, African-American children are less likely to use LDLT but have higher rates of DDLT and similar survival on the waitlist.
AHRQ-funded; HS024600; HS023876.
Citation: Mogul DB, Luo X, Chow EK .
Impact of race and ethnicity on outcomes for children waitlisted for pediatric liver transplantation.
J Pediatr Gastroenterol Nutr 2018 Mar;66(3):436-41. doi: 10.1097/mpg.0000000000001793.
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Keywords: Children/Adolescents, Healthcare Utilization, Racial and Ethnic Minorities, Outcomes, Transplantation