DR. AMY FELDMAN, M.D.

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Researchers studied the key areas needing improvement in pediatric liver transplantation (LT) care, finding that only one-third of children are healthy 10 years after receiving a transplant. They identified 46 high-priority research topics, including better tools for organ allocation and new methods to preserve organs. This research agenda is important because it aims to improve the survival rates and overall health of children who undergo liver transplants.

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This study looked at how well children with chronic liver disease respond to measles and chickenpox vaccines compared to healthy children. It found that all 21 children with liver disease and 13 healthy children had strong immune responses to both vaccines, with 100% effectiveness for measles and 94% for chickenpox. This matters because safely giving these vaccines to children with liver disease before a transplant can help protect them from serious infections.

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This study looked at young children under two years old with biliary atresia who received liver transplants between 2013 and 2022. It found that those who received liver transplants from living donors had better survival rates compared to those who got organs from deceased donors: living donor transplants had a significantly lower risk of death and graft loss. This matters because it highlights the importance of increasing access to living donor transplants for these young patients to improve their chances of survival.

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This study looked at how well certain muscle responses, called the tonic stretch reflex threshold (TSRT) and its sensitivity (μ), relate to upper limb movement problems in stroke patients. The researchers found that these measures accounted for 72% of the differences in motor function scores among 120 patients, indicating a strong connection between reflex issues and motor impairment. This matters because TSRT and μ could help doctors better track recovery or the effectiveness of treatments for stroke patients’ movement challenges.

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Researchers studied the costs associated with treating biliary strictures in children who received liver transplants. They found that 42% of the patients achieved the best possible outcome after undergoing a median of 4 procedures and spending 2 nights in the hospital, compared to others who faced more procedures and longer stays. This matters because it shows that addressing issues early and effectively can lower treatment costs and improve overall care for these young patients.

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Researchers tested a smartphone app called Immunize PediatricTransplant to see if it could help increase the number of children getting necessary vaccines before organ transplants. The results showed that 96% of the 25 children using the app were up to date on their vaccines by the time of transplant, and most parents and doctors felt the app was useful and recommended it to others. This matters because higher vaccination rates can lead to fewer infections after transplant, improving children's health outcomes.

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This study looked at how pediatric liver transplant centers in the U.S. handle live viral vaccines for children after liver transplants. Researchers found that while most centers (85%) start giving these vaccines to children at six months old, nearly 40% still don’t recommend them after a transplant due to safety concerns. This matters because it highlights that, despite updated guidelines supporting the use of these vaccines, many centers struggle to implement them fully, which could affect the health of transplant recipients.

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This study looked at how frogs and humans can perform precise movements, like wiping away an irritant on their skin or hammering, even when their body positions change. Researchers found that frogs, even when their limbs were moved around, could still accurately wipe an irritant off their skin, while humans maintained consistent hammering despite varying arm positions. This matters because it offers new insights into how our brains and bodies work together to control movement and perception, which could change how we understand physical actions.

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This study looked at how machine perfusion (MP), a method to keep donor livers healthy longer, affects liver transplants in children. Researchers compared 40 children who received livers using machine perfusion to over 3,800 children who did not, finding that those with MP were more likely to have older donor organs and longer preservation times. The good news is that using MP did not harm survival rates for the children, which means it could improve access to healthy organs for sick kids in need of a transplant.

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This study looked at how different liver transplant centers manage medications given to children right after they receive a transplant. It found that centers with more consistent medication practices had a significantly lower likelihood—2.72 times less likely—of the child experiencing organ rejection within the first year. Understanding and reducing differences in these medication approaches could help improve transplant outcomes for kids.

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This study looked at liver transplant outcomes in children with a type of liver cancer called hepatic undifferentiated embryonal sarcoma (HUES). Researchers found that kids with HUES who received a transplant had similar survival rates to those with another type of liver cancer and those who had transplants for non-cancer reasons, with a one-year survival rate of about 90% and a five-year rate of around 80%. This is important because it shows that liver transplants can be a successful treatment option for children with this rare cancer, even if it was previously thought to have poor outcomes.

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This study looked at how vaccinated children who received solid organ transplants were affected by Omicron infections. It found that these children got infected frequently, even though they had strong antibody responses. However, the infections were generally not severe. This matters because it highlights the ongoing risk of COVID-19 for vulnerable groups, even with vaccination.

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The study looked at how long antibodies lasted after three COVID-19 vaccine doses in teenagers who had received organ transplants. Six months after the third shot, all 34 participants still had measurable antibodies, though about 29% showed decreased levels. This matters because it indicates that while these teens maintain some immunity for at least six months, they still had a few breakthrough infections, highlighting the continuous risk from new virus variants.

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This study looked at how people who have had a stroke reach for objects while standing or stepping. Researchers found that stroke survivors had more difficulty coordinating their arm and body movements, which made reaching less effective—specifically, their movements were delayed and less balanced compared to healthy individuals. This matters because better understanding these coordination issues can lead to improved therapies that help stroke survivors regain their ability to move and reach for things more effectively.

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This study looked at how adults shift their body weight from side to side while standing and stepping. Researchers found that when participants sidestepped, their body posture could briefly align with an ideal posture, allowing their muscles to relax and minimizing muscle activity. This finding is important because it shows that the way we move side to side involves a complex system that helps maintain balance efficiently.

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This study looked at three networks designed to improve health care for children needing organ transplants, especially during the challenges posed by the COVID-19 pandemic. It found that involving patients and their families is key to making these networks effective; for example, they adapted quickly to better serve their needs. Recognizing these networks is important because they help share information and improve health outcomes for children undergoing transplantation.

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This study looked at the long-term health of children who received liver transplants and stopped taking immunosuppressive drugs compared to those who continued on these medications. It found that among 33 children off the drugs, none needed another transplant or experienced worse health issues compared to 66 similar children who stayed on the medication, indicating they fared equally well. This is important because it shows that some pediatric liver transplant patients may be able to live without these medications safely, reducing their risk of side effects.

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This study looked at how different early treatments to suppress the immune system affect the success of liver transplants in kids during their first year after surgery. It found that using a type of antibody called T-cell depleting antibodies can improve chances of survival in some cases but may also increase risks in others, showing contrasting results in two data sources. Overall, the research highlights the need for better teamwork among hospitals to find the best treatment strategies for these young patients.

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This study looked at how different types of liver grafts—whole liver grafts (WLG) and technical variant grafts (TVG)—affect outcomes for children receiving liver transplants. Researchers found that after three years, survival rates were similar for both types: around 96% for patients with TVG and about 92% for those with WLG. The findings indicate that using TVG more widely could help reduce the number of children dying while waiting for a liver transplant.

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This study looked at how the type of insurance affects the chances of children receiving liver transplants from living donors. Of 299 children who received these transplants, 15% came from non-directed living donors, with those on public insurance being more likely to receive this type of donation (59% compared to 40% for directed donors). The findings highlight that non-directed living donations could help more children with public insurance get liver transplants, but they currently make up a small part of all donations, suggesting a need for better access to these procedures.

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This study looked at a case of a previously healthy child who suffered severe liver failure, which was linked to adenovirus, a virus typically not known to cause such serious liver issues. The child showed traces of adenovirus in his stool, blood, and liver tissue, and there was no sign of past COVID-19 infection or vaccination. This case is significant because it highlights the potential danger of adenovirus in causing severe liver problems in children and the effectiveness of a quick liver transplant from a living donor.

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This study looked at the COVID-19 vaccination policies of pediatric organ transplant centers in the U.S. Out of the centers surveyed, only 23% for kids aged 5-15 and 32% for those 16 and older require the vaccine for transplant candidates, while about 20% accept organs from donors who passed away with COVID-19. The findings highlight significant differences in vaccine policies across centers, which raises concerns about fairness and equal access to transplants for children.

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Researchers studied how blocking vision affects human walking by observing how responses shift when we can't see. They found that temporarily losing sight slows how our bodies adjust to maintain balance, changing the movement of our limbs briefly before normal walking resumes. This matters because it shows how our brains and bodies coordinate movement using both visual and physical cues, helping us understand balance and motion better.

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This study looked at the importance of vaccinations for people who need or have received organ transplants. It found that vaccines are safe and help prevent serious infections in these patients, making them a key part of their care both before and after surgery. The research highlights the need for better tools to keep healthcare providers updated on the latest vaccine guidelines so they can better protect transplant patients.

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This study looked at how our nervous system controls arm movements by adjusting specific positions of muscles. Researchers found that during various arm movements, there were moments when muscle activity decreased significantly, happening when the arm was about 61%-86% of the way to its target. Understanding how these muscle activations work is important because it helps us better grasp how the body coordinates movements, which could improve rehabilitation strategies for people with movement disorders.

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This research is studying how stroke survivors can improve their arm movement skills using a feedback method called error augmentation. In a trial with 52 participants, they will practice reaching movements three times a week for nine weeks, either with or without this special feedback. The goal is to see how well this method helps improve their movement accuracy and speed, which could lead to better rehabilitation techniques for those with chronic stroke-related disabilities.

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This study looked at the effects of cytomegalovirus (CMV) infection on infants with biliary atresia, a serious liver condition. It found that infants with CMV were diagnosed later and had worse liver injury, leading to almost four times the risk of dying before receiving a liver transplant compared to those without CMV. However, having CMV did not affect the likelihood of surviving with their own liver after surgery, which is important for understanding how to manage these patients effectively.

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A group of educators created a Zoom lecture series to improve training for pediatric liver transplant specialists in the U.S. and Canada. Out of 16 participants, 88% felt that the series boosted their knowledge and confidence about managing children's liver diseases, and 81% appreciated the networking opportunities it provided. This program is important because it fills a gap in education and helps train doctors who care for children with serious liver conditions.

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This multicenter study examined whether live vaccines for measles, mumps, rubella, and varicella are safe and effective in children who had received solid organ transplants, including 281 recipients from 18 centers. The majority of children developed protective antibody levels after vaccination, most maintained protection at one year, and serious adverse events were rare — with only five mild varicella cases and no graft rejections following vaccination. The results support reconsidering blanket restrictions on live vaccines for selected, stable pediatric transplant recipients.

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During the COVID-19 pandemic, access to liver transplants for children in the U.S. dropped significantly. There was a 25% decrease in new patients added to the transplant waitlist and a 38% reduction in actual transplants during the early months of the pandemic. This is important because non-white children were hit hardest, with a 44% drop in overall transplants, highlighting ongoing racial inequalities in healthcare access.

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This study looked at how malnutrition affects infants with biliary atresia, a liver condition that makes it hard for them to eat and absorb nutrients. It found that malnutrition leads to more health problems and increased chances of complications both before and after liver transplants. Understanding and addressing malnutrition in these infants is crucial because it can improve their overall health and reduce serious risks during treatment.

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The study looked at how to manage biliary strictures in children who received liver transplants, finding that about 4% to 12% of these kids develop strictures that can harm their new liver if not treated. Among 113 children studied, 92% had their strictures resolved, but 20% experienced a recurrence, particularly those with related complications like hepatic artery thrombosis. This research is important because it helps identify effective treatments for biliary strictures, which can significantly affect the success of liver transplants in children.

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Researchers studied how the texture and weight of objects affect control of wrist muscles when using both hands. They found that when the participants held a smooth block, their wrist muscles reacted more strongly, regardless of how hard they were lifting. This shows that the brain controls how much the muscles respond based on the feel of the object, which is important for improving coordination and handling of objects with two hands.

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Researchers developed a smartphone app called Immunize PediatricTransplant to help ensure that children waiting for solid organ transplants get all their necessary vaccinations. In testing, users were able to enter vaccination information with 87% accuracy and rated the app highly for its engagement and functionality, scoring it between 4.2 and 4.8 out of 5. This matters because it could significantly improve vaccination rates in these vulnerable children, who are often not up-to-date on their immunizations before their transplants, aiming to reduce the risk of serious infections.

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This study looked at how COVID-19 affected children who have received solid organ transplants. It found that the pandemic made it harder for these kids to get organ transplants and also increased their risk of serious illness from the virus. Understanding these impacts is important because it helps improve care and safety for these vulnerable children as they navigate their health during the pandemic.

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This study looked at how our eyes and brain work together to coordinate movement and perception. Researchers found that when we prepare to move our eyes, the brain shifts the way it processes visual information, which helps align sight with physical actions, like reaching for something. This understanding is important because it could lead to better treatments for movement issues in conditions like Parkinson's disease.

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This study looked at the impact of COVID-19 on vaccination rates, finding that many children are not getting their routine vaccines due to the pandemic. As a result, there’s a serious risk of outbreaks of dangerous diseases like measles and polio, especially when kids go back to school. To prevent this, healthcare providers need to work closely with public health officials and community leaders to encourage families to vaccinate their children safely.

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This study looked at recent graduates of pediatric transplant hepatology (PTH) fellowships to understand their training and experiences. Out of 43 graduates, 38 responded, and most (95%) completed a research project during their fellowship. While the fellowship is widely viewed positively and 84% of graduates now work at academic transplant centers, there is inconsistency in the training each program offers, suggesting a need for better standardization.

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This study looked at how humans move and maintain balance while walking and running. Researchers found that the speed of movement depends on how quickly the body adjusts its posture to avoid falling. Understanding this process helps reveal how our muscles work together during movement and could lead to new insights for treating movement-related disorders.

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This research focuses on cholestasis, a liver condition that can cause jaundice in newborns and young infants. It found that new genetic testing techniques can quickly identify many underlying causes of cholestasis, which is important for effective treatment. Additionally, improvements in nutrition methods have reduced liver disease rates in infants on long-term feeding support, but challenges remain, particularly with conditions like biliary atresia, which often requires liver transplants. Understanding and diagnosing these liver issues better can lead to improved health outcomes for affected infants.