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Article ; Online: Update on the management of vasoproliferative tumour.

Temblador-Barba, I / Delgado-Alonso, E M / Toribio-García, M / Martínez-Campillo, L / Molina-Leyva, I / Martínez-Jiménez, M

Archivos de la Sociedad Espanola de Oftalmologia

2018 Volume 93, Issue 7, Page(s) 350–353

Abstract: Case report: Here we report a 19-year-old female patient who presented a vasoproliferative tumour. It caused complications, such as epiretinal membrane, macular oedema, vitreous haemorrhage, and exudative retinal detachment. The patient was treated with ...

Title translation	Actualización sobre el manejo del tumor vasoproliferativo.
Abstract	Case report: Here we report a 19-year-old female patient who presented a vasoproliferative tumour. It caused complications, such as epiretinal membrane, macular oedema, vitreous haemorrhage, and exudative retinal detachment. The patient was treated with 3 injections of intravitreal bevacizumab, an intravitreal dexamethasone implant, tocilizumab, and double freeze-thaw cryotherapy. Discussion: Therapeutic options are: observation, if it is small, if it is a peripheral lesion, and if there seems to be no threat to vision. If it requires treatment, laser photocoagulation, intravitreal bevacizumab, trans-conjunctival cryotherapy, transpupillary thermotherapy, photodynamic therapy, brachytherapy plaques and surgery are the different options available. Recently, tocilizumab and intravitreal dexamethasone implants have been reported to be beneficial.
MeSH term(s)	Angiogenesis Inhibitors ; Antibodies, Monoclonal, Humanized/administration & dosage ; Antineoplastic Agents, Immunological/administration & dosage ; Bevacizumab/administration & dosage ; Combined Modality Therapy ; Cryotherapy ; Dexamethasone/administration & dosage ; Female ; Glucocorticoids/administration & dosage ; Humans ; Intravitreal Injections ; Retinal Neoplasms/therapy ; Young Adult
Chemical Substances	Angiogenesis Inhibitors ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents, Immunological ; Glucocorticoids ; Bevacizumab (2S9ZZM9Q9V) ; Dexamethasone (7S5I7G3JQL) ; tocilizumab (I031V2H011)
Language	Spanish
Publishing date	2018-02-16
Publishing country	Spain
Document type	Case Reports ; Journal Article
ISSN	2173-5794
ISSN (online)	2173-5794
DOI	10.1016/j.oftal.2018.01.005
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Article: Infant survival after orthotopic liver transplantation.

Alonso, E M

Journal of pediatric gastroenterology and nutrition

1998 Volume 27, Issue 5, Page(s) 611–613

MeSH term(s)	Age Factors ; Graft Survival ; Histocompatibility Testing ; Humans ; Infant ; Liver Transplantation/mortality ; Transplantation, Homologous ; Treatment Outcome
Language	English
Publishing date	1998-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/00005176-199811000-00024
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Article ; Online: Once daily calcineurin inhibitor monotherapy in pediatric liver transplantation.

Ekong, U D / Bhagat, H / Alonso, E M

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2010 Volume 10, Issue 4, Page(s) 883–888

Abstract: This report describes a group of pediatric liver transplant recipients who have undergone once daily calcineurin inhibitor (CNI) monotherapy at Children's Memorial Hospital, Chicago, between January 1, 2001 and November 30, 2008. We defined success as ... ...

Abstract	This report describes a group of pediatric liver transplant recipients who have undergone once daily calcineurin inhibitor (CNI) monotherapy at Children's Memorial Hospital, Chicago, between January 1, 2001 and November 30, 2008. We defined success as normal liver enzymes at 1 year after dose change, with normal enzymes throughout all follow-up. Patients who did not meet the set criteria or had lost an organ to chronic rejection were not considered for this therapeutic strategy. There were 147 patients in our organ transplant tracking record (OTTR) who were > or = 5 years post liver transplant. Of these, 56 underwent reduced dose, once daily CNI monotherapy. Patients who met the set criteria were placed on once daily calcineurin inhibitor at half their previous dose. Fifty patients successfully achieved this dose change, while six patients failed at a mean of 3.7 +/- 3.2 months following the dosing change. The mean interval from transplant was significantly longer in those patients who were successful compared to those who failed dose change (p < 0.05). Importantly, there have been no graft losses. Reduced dose, once daily CNI monotherapy is safe in carefully selected recipients, with a longer interval post liver transplantation increasing the likelihood of success.
MeSH term(s)	Calcineurin/administration & dosage ; Child ; Child, Preschool ; Double-Blind Method ; Humans ; Infant ; Liver Transplantation ; Placebos
Chemical Substances	Placebos ; Calcineurin (EC 3.1.3.16)
Language	English
Publishing date	2010-03-26
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/j.1600-6143.2010.03061.x
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Article ; Online: Risk factors for chronic anemia in pediatric orthotopic liver transplantation: analysis of data from the SPLIT registry.

Liem, R I / Anand, R / Yin, W / Alonso, E M

Pediatric transplantation

2011 Volume 16, Issue 2, Page(s) 137–143

Abstract: Risk factors for chronic anemia in the post-transplant period have not been clearly delineated in pediatric liver transplant recipients. We analyzed data from children transplanted from 2000 to 2008 with at least two consecutive hemoglobin values from ... ...

Abstract	Risk factors for chronic anemia in the post-transplant period have not been clearly delineated in pediatric liver transplant recipients. We analyzed data from children transplanted from 2000 to 2008 with at least two consecutive hemoglobin values from follow-up between six months and five yr post-transplant. A multivariate model was derived to determine independent risk factors associated with chronic anemia. Of 1026 children in this analysis, 242 (23.6%) were found to have chronic anemia. On multivariate analysis, GI bleeding (OR 11.83 [2.08-67.49], p = 0.0054), presence of leukopenia (OR 9.55 [95% CI 3.71-24.62], p < 0.0001), use of cyclosporine (OR 3.69, [95% CI 1.56-8.76], p = 0.0039) and corticosteroids (OR 2.90 [95% CI 1.94-4.33], p < 0.0001), and cGFR <90 mL/min/1.73 m(2) (OR 4.62 [95% CI 2.47-8.67], p < 0.0001) represented the most significant risk factors for chronic anemia. Use of antihypertensive medications (OR 1.89 [95% CI 1.23-2.91], p = 0.0039) was also significantly associated with a higher risk. In summary, chronic anemia is common in children following liver transplant. Our findings underscore the need to define the mechanisms by which these risk factors, some of which are modifiable, result in chronic anemia in pediatric liver transplant recipients.
MeSH term(s)	Adolescent ; Anemia/diagnosis ; Anemia/epidemiology ; Anemia/etiology ; Child ; Child, Preschool ; Chronic Disease ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Humans ; Infant ; Liver Transplantation ; Logistic Models ; Male ; Multivariate Analysis ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prevalence ; Registries ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2011-12-21
Publishing country	Denmark
Document type	Evaluation Study ; Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
ZDB-ID	1390284-2
ISSN	1399-3046 ; 1397-3142
ISSN (online)	1399-3046
ISSN	1397-3142
DOI	10.1111/j.1399-3046.2011.01631.x
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Article ; Online: Posttransplant metabolic syndrome in the withdrawal of immunosuppression in Pediatric Liver Transplant Recipients (WISP-R) pilot trial.

Perito, E R / Mohammad, S / Rosenthal, P / Alonso, E M / Ekong, U D / Lobritto, S J / Feng, S

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2015 Volume 15, Issue 3, Page(s) 779–785

Abstract: Posttransplant metabolic syndrome (PTMS)-obesity, hypertension, elevated triglycerides, low HDL and glucose intolerance-is a major contributor to morbidity after adult liver transplant. This analysis of the Withdrawal of Immunosuppression in Pediatric ... ...

Abstract	Posttransplant metabolic syndrome (PTMS)-obesity, hypertension, elevated triglycerides, low HDL and glucose intolerance-is a major contributor to morbidity after adult liver transplant. This analysis of the Withdrawal of Immunosuppression in Pediatric Liver Transplant Recipients (WISP-R) pilot trial is the first prospective study of PTMS after pediatric liver transplant. Twenty children were enrolled in WISP-R, at median age 8.5 years (IQR 6.4-10.8), and weaned from calcineurin-inhibitor monotherapy. The 12 children who tolerated complete immunosuppression withdrawal were compared to matched historical controls. At baseline, 45% of WISP-R subjects and 58% of controls had at least one component of PTMS. Calcineurin-inhibitor withdrawal in the WISP-R subjects did not impact the prevalence of PTMS components compared to controls. At 5 years, despite weaning off of immunosuppression, 92% of the 12 tolerant WISP-R subjects had at least one PTMS component and 58% had at least two; 33% were overweight or obese, 50% had dyslipidemia, 33% glucose intolerance and 42% systolic hypertension. Overweight/obesity increased the risk of hypertension in all children. Compared to controls, WISP-R tolerant subjects had similar GFR at baseline but did have higher GFR at 2, 3 and 4 years. Further study of PTMS and immunosuppression withdrawal after pediatric liver transplant is warranted.
MeSH term(s)	Child ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/administration & dosage ; Liver Transplantation/adverse effects ; Metabolic Syndrome/etiology ; Retrospective Studies
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2015-02-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/ajt.13024
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Article: Fulminant hepatitis in children: evidence for an unidentified hepatitis virus.

Whitington, P F / Alonso, E M

Journal of pediatric gastroenterology and nutrition

2001 Volume 33, Issue 5, Page(s) 529–536

MeSH term(s)	Acute Disease ; Child ; Hepatic Encephalopathy/mortality ; Hepatic Encephalopathy/surgery ; Hepatic Encephalopathy/virology ; Hepatitis, Viral, Human/complications ; Hepatitis, Viral, Human/mortality ; Hepatitis, Viral, Human/surgery ; Humans ; Liver Failure/mortality ; Liver Failure/surgery ; Liver Failure/virology ; Liver Transplantation ; Prognosis ; Survival Rate
Language	English
Publishing date	2001-12-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/00005176-200111000-00004
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Article ; Online: The Medication Level Variability Index (MLVI) Predicts Poor Liver Transplant Outcomes: A Prospective Multi-Site Study.

Shemesh, E / Bucuvalas, J C / Anand, R / Mazariegos, G V / Alonso, E M / Venick, R S / Reyes-Mugica, M / Annunziato, R A / Shneider, B L

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2017 Volume 17, Issue 10, Page(s) 2668–2678

Abstract: Nonadherence to immunosuppressant medications is a leading cause of poor long-term outcomes in transplant recipients. The Medication Level Variability Index (MLVI) provides a vehicle for transplant outcome risk-stratification through continuous ... ...

Abstract	Nonadherence to immunosuppressant medications is a leading cause of poor long-term outcomes in transplant recipients. The Medication Level Variability Index (MLVI) provides a vehicle for transplant outcome risk-stratification through continuous assessment of adherence. The MALT (Medication Adherence in children who had a Liver Transplant) prospective multi-site study evaluated whether MLVI predicts late acute rejection (LAR). Four hundred pediatric (1-17-year-old) liver transplant recipients were enrolled and followed for 2 years. The a-priori hypothesis was that a higher MLVI predicts LAR. Predefined secondary analyses evaluated other outcomes such as liver enzyme levels, and sensitivity analyses compared adolescents to pre-adolescents. In the primary analysis sample of 379 participants, a higher prerejection MLVI predicted LAR (mean prerejection MLVI with LAR: 2.4 [3.6 standard deviation] versus without LAR, 1.6 [1.1]; p = 0.026). Fifty-three percent of the adolescents with MLVI>2 in year 1 had LAR by the end of year 2, as compared with 6% of those with year 1 MLVI≤2. A higher MLVI was significantly associated with all secondary outcomes. MLVI, a marker of medication adherence that uses clinically derived information, predicts LAR in pediatric liver transplant recipients.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Cohort Studies ; Graft Rejection ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/blood ; Infant ; Liver Transplantation ; Patient Compliance ; Prospective Studies ; Tacrolimus/administration & dosage ; Tacrolimus/blood ; Treatment Outcome
Chemical Substances	Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2017-04-22
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/ajt.14276
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Article ; Online: Cognitive and academic outcomes after pediatric liver transplantation: Functional Outcomes Group (FOG) results.

Sorensen, L G / Neighbors, K / Martz, K / Zelko, F / Bucuvalas, J C / Alonso, E M

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2011 Volume 11, Issue 2, Page(s) 303–311

Abstract: This multicenter study examined prevalence of cognitive and academic delays in children following liver transplant (LT). One hundred and forty-four patients ages 5-7 and 2 years post-LT were recruited through the SPLIT consortium and administered the ... ...

Abstract	This multicenter study examined prevalence of cognitive and academic delays in children following liver transplant (LT). One hundred and forty-four patients ages 5-7 and 2 years post-LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI-III), the Bracken Basic Concept Scale, Revised (BBCS-R), and the Wide Range Achievement Test, 4th edition (WRAT-4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI-III Full Scale IQ = 94.7 ± 13.5; WRAT-4 Reading = 92.7 ± 17.2; WRAT-4 Math = 93.1 ± 15.4; p < 0001). Twenty-six percent of patients (14% expected) had 'mild to moderate' IQ delays (Full Scale IQ = 71-85) and 4% (2% expected) had 'serious' delays (Full Scale IQ ≤ 70; p < 0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC statistics (p < 0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p < 0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population.
MeSH term(s)	Child ; Child, Preschool ; Cognition ; Cognition Disorders/etiology ; Cohort Studies ; Educational Status ; Executive Function ; Female ; Humans ; Intelligence Tests ; Learning Disabilities/etiology ; Liver Transplantation/adverse effects ; Liver Transplantation/psychology ; Longitudinal Studies ; Male ; Psychometrics ; Registries ; United States
Language	English
Publishing date	2011-01-10
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/j.1600-6143.2010.03363.x
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Article ; Online: Blood pressure elevation in long-term survivors of pediatric liver transplantation.

McLin, V A / Anand, R / Daniels, S R / Yin, W / Alonso, E M

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2011 Volume 12, Issue 1, Page(s) 183–190

Abstract: As pediatric liver transplant (LT) recipients come of age, additional insight into long-term medical complications of immunosuppression is warranted. The aims of this study were to estimate the prevalence of elevated blood pressure (BP) in long-term ... ...

Abstract	As pediatric liver transplant (LT) recipients come of age, additional insight into long-term medical complications of immunosuppression is warranted. The aims of this study were to estimate the prevalence of elevated blood pressure (BP) in long-term survivors of pediatric LT using the data from the Studies in Pediatric Liver Transplantation (SPLIT) database and to identify predictive factors. Patients enrolled in the BP arm of the SPLIT cohort participated in the study. All patients were of at least 5 years but ≤10 years post-LT. Automated BP measurements were obtained at anniversary visits. BP measures were classified as normal, borderline or elevated according to standard criteria. Patients taking antihypertensive medications were classified as "elevated." Eight hundred and fifteen patients participated. The prevalence of elevated BP measurements 5 to 10 years post-LT was 17.5 to 27.5%. Of total 62.5% patients presented with at least one additional elevated BP at a later follow up visit. Multivariate analysis revealed the following parameters to be predictive of elevated BP: age at transplant, steroid use at last BP measurement and cGFR at last BP measurement. Pediatric LT patients show a high prevalence of elevated BP measurements 5 to 10 years following LT, which is related to age at LT, decreased cGFR and recent steroid use.
MeSH term(s)	Antihypertensive Agents/therapeutic use ; Child ; Cohort Studies ; Female ; Humans ; Hypertension/drug therapy ; Hypertension/etiology ; Liver Transplantation ; Male ; Survivors
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2011-10-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/j.1600-6143.2011.03772.x
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Article: Portal hypertension in children.

Alonso, E M / Hackworth, C / Whitington, P F

Clinics in liver disease

2004 Volume 1, Issue 1, Page(s) 201–22, xiii

Abstract: This chapter reviews the common causes of portal hypertension in children. It specifies how the treatment strategy for portal hypertension in patients without significant hepatic dysfunction differs from the management of children with cirrhosis. It ... ...

Abstract	This chapter reviews the common causes of portal hypertension in children. It specifies how the treatment strategy for portal hypertension in patients without significant hepatic dysfunction differs from the management of children with cirrhosis. It describes the application of newer treatment modalities such as TIPS and partial splenic embolization in children and reviews the current recommendations for surgical intervention in these patients.
MeSH term(s)	Ascites/etiology ; Ascites/therapy ; Child ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/prevention & control ; Humans ; Hypersplenism/etiology ; Hypersplenism/therapy ; Hypertension, Portal/complications ; Hypertension, Portal/diagnosis ; Hypertension, Portal/therapy ; Portasystemic Shunt, Surgical
Language	English
Publishing date	2004-11-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1472315-3
ISSN	1557-8224 ; 1089-3261
ISSN (online)	1557-8224
ISSN	1089-3261
DOI	10.1016/s1089-3261(05)70264-6
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