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Review Article
Cardiology
Pediatric heart transplantation: how to manage problems affecting long-term outcomes?
Young Hwue Kim
Clin Exp Pediatr. 2021;64(2):49-59.   Published online April 8, 2020
Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500–550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart...
Gastroenterology
Increasing incidence of inflammatory bowel disease in children and adolescents: significance of environmental factors
Sowon Park, Yunkoo Kang, Hong Koh, Seung Kim
Clin Exp Pediatr. 2020;63(9):337-344.   Published online December 6, 2019
Inflammatory bowel disease (IBD) is a chronic relapsing immune-mediated disease of the intestinal tract. Although its prevalence is reportedly lower in Asia than in Western countries, the rapid increase in the incidence of IBD has drawn attention to its etiology, including genetic susceptibility and environmental factors. Specifically, recent studies concerning dietary treatments and intestinal microbiota suggest that these factors may...
Nephrology (Genitourinary)
Pediatric kidney transplantation is different from adult kidney transplantation
Min Hyun Cho
Clin Exp Pediatr. 2018;61(7):205-209.   Published online July 15, 2018
Kidney transplantation (KT) is the gold standard for renal replacement therapy in pediatric patients with end-stage renal disease. Recently, it has been observed that the outcome of pediatric KT is nearly identical to that in adults owing to the development and application of a variety of immunosuppressants and newer surgical techniques. However, owing to several differences in characteristics between children...
Original Article
Oncology
Posttransplantation lymphoproliferative disorder after pediatric solid organ transplantation: experiences of 20 years in a single center
Hyung Joo Jeong, Yo Han Ahn, Eujin Park, Youngrok Choi, Nam-Joon Yi, Jae Sung Ko, Sang Il Min, Jong Won Ha, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang
Clin Exp Pediatr. 2017;60(3):86-93.   Published online March 27, 2017
Purpose

To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children.

Methods

We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital.

Results

Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed...

Case Report
Oncology
Targeted busulfan and fludarabine-based conditioning for bone marrow transplantation in chronic granulomatous disease
Hee Young Ju, Hyoung Jin Kang, Che Ry Hong, Ji Won Lee, Hyery Kim, Sang Hoon Song, Kyung-Sang Yu, In-Jin Jang, June Dong Park, Kyung Duk Park, Hee Young Shin, Joong-Gon Kim, Hyo Seop Ahn
Clin Exp Pediatr. 2016;59(Suppl 1):S57-S59.   Published online November 30, 2016

Chronic granulomatous disease (CGD) is a primary immunodeficiency disease caused by impaired phagocytic function. Hematopoietic stem cell transplantation (HSCT) is a definitive cure for CGD; however, the use of HSCT is limited because of associated problems, including transplantation-related mortality and engraftment failure. We report a case of a patient with CGD who underwent successful HSCT following a targeted busulfan and...

Nephrology (Genitourinary)
Deficiency of antidiuretic hormone: a rare cause of massive polyuria after kidney transplantation
Kyung Mi Jang, Young Soo Sohn, Young Ju Hwang, Bong Seok Choi, Min Hyun Cho
Clin Exp Pediatr. 2016;59(4):202-204.   Published online April 30, 2016

A 15-year-old boy, who was diagnosed with Alport syndrome and end-stage renal disease, received a renal transplant from a living-related donor. On postoperative day 1, his daily urine output was 10,000 mL despite normal graft function. His laboratory findings including urine, serum osmolality, and antidiuretic hormone levels showed signs similar to central diabetes insipidus, so he was administered desmopressin acetate...

Original Article
Cardiology
Subclinical left ventricular dysfunction in children after hematopoietic stem cell transplantation for severe aplastic anemia: a case control study using speckle tracking echocardiography
Beom Joon Kim, Kyung Pil Moon, Ji-Hong Yoon, Eun-Jung Lee, Jae Young Lee, Seong Koo Kim, Jae Wook Lee, Nack Gyun Chung, Bin Cho, Hack Ki Kim
Clin Exp Pediatr. 2016;59(4):190-195.   Published online April 30, 2016
Purpose

Severe aplastic anemia (SAA), a fatal disease, requires multiple transfusion, immunosuppressive therapy, and finally, hematopoietic stem cell transplantation (HSCT) as the definitive treatment. We hypothesized that iron overloading associated with multiple transfusions and HSCTrelated complications may adversely affect cardiac function. Left ventricular (LV) function was assessed in children after HSCT for SAA.

Methods

Forty-six consecutive patients with a median age of 9.8...

Case Report
Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition
Huee Jin Park, Kyung Hoon Kim, Hyuk Jin Lee, Eui Cheol Jeong, Kee Won Kim, Dong In Suh
Clin Exp Pediatr. 2015;58(11):454-458.   Published online November 22, 2015

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain...

Review Article
Haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia
Ho Joon Im, Kyung-Nam Koh, Jong Jin Seo
Clin Exp Pediatr. 2015;58(6):199-205.   Published online June 22, 2015

Severe aplastic anemia (SAA) is a life-threatening disorder for which allogeneic hematopoietic stem cell transplantation (HSCT) is the current available curative treatment. HSCT from matched sibling donors (MSDs) is the preferred therapy for children with acquired SAA. For patients who lack MSDs, immunosuppressive therapy (IST) is widely accepted as a first-line treatment before considering HCT from an unrelated donor (URD)....

BK virus-associated hemorrhagic cystitis after pediatric stem cell transplantation
Seung Beom Han, Bin Cho, Jin Han Kang
Clin Exp Pediatr. 2014;57(12):514-519.   Published online December 31, 2014

Hemorrhagic cystitis is a common stem cell transplantation-related complication. The incidence of early-onset hemorrhagic cystitis, which is related to the pretransplant conditioning regimen, has decreased with the concomitant use of mesna and hyperhydration. However, late-onset hemorrhagic cystitis, which is usually caused by the BK virus, continues to develop. Although the BK virus is the most common pathogenic microorganism of poststem...

Mesenchymal stem cells transplantation for neuroprotection in preterm infants with severe intraventricular hemorrhage
So Yoon Ahn, Yun Sil Chang, Won Soon Park
Clin Exp Pediatr. 2014;57(6):251-256.   Published online June 30, 2014

Severe intraventricular hemorrhaging (IVH) in premature infants and subsequent posthemorrhagic hydrocephalus (PHH) causes significant mortality and life-long neurological complications, including seizures, cerebral palsy, and developmental retardation. However, there are currently no effective therapies for neonatal IVH. The pathogenesis of PHH has been mainly explained by inflammation within the subarachnoid spaces due to the hemolysis of extravasated blood after IVH. Obliterative...

Original Article
Long-term follow-up of Fanconi anemia: clinical manifestation and treatment outcome
Byung Gyu Yoon, Hee Na Kim, Ui Joung Han, Hae In Jang, Dong Kyun Han, Hee Jo Baek, Tai Ju Hwang, Hoon Kook
Clin Exp Pediatr. 2014;57(3):125-134.   Published online March 31, 2014
Purpose

The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease.

Methods

The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed.

Results

The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more...

Review Article
Clinical utilization of cord blood over human health: experience of stem cell transplantation and cell therapy using cord blood in Korea
Young-Ho Lee
Clin Exp Pediatr. 2014;57(3):110-116.   Published online March 31, 2014

Cord blood (CB) has been used as an important and ethical source for hematopoietic stem cell transplantation (SCT) as well as cell therapy by manufacturing mesenchymal stem cell, induced pleuripotential stem cell or just isolating mononuclear cell from CB. Recently, the application of cell-based therapy using CB has expanded its clinical utility, particularly, by using autologous CB in children with...

Original Article
High-dose chemotherapy and autologous peripheral blood stem cell transplantation in the treatment of children and adolescents with Ewing sarcoma family of tumors
Juhee Seo, Dong Ho Kim, Jung Sub Lim, Jae-Soo Koh, Ji Young Yoo, Chang-Bae Kong, Won Seok Song, Wan Hyeong Cho, Dae-Geun Jeon, Soo-Yong Lee, Jun Ah Lee
Clin Exp Pediatr. 2013;56(9):401-406.   Published online September 30, 2013
Purpose

We performed a pilot study to determine the benefit of high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDCT/autoPBSCT) for patients with Ewing sarcoma family of tumors.

Methods

We retrospectively analyzed the data of patients who received HDCT/autoPBSCT at Korea Cancer Center Hospital. Patients with relapsed, metastatic, or centrally located tumors were eligible for the study.

Results

A total of 9 patients (3...

Efficacy of imatinib mesylate-based front-line therapy in pediatric chronic myelogenous leukemia
Hyun Jin Oh, Mun Sung Cho, Jae Wook Lee, Pil-Sang Jang, Nack-Gyun Chung, Bin Cho, Hack-Ki Kim
Clin Exp Pediatr. 2013;56(8):343-350.   Published online August 27, 2013
Purpose

Despite the established role of imatinib (IM) in chronic myelogenous leukemia (CML) in adults, there are few reports on its efficacy in children. In this study, we compared the outcomes of children with CML before and after the advent of IM-based treatment.

Methods

The study cohort consisted of 52 patients treated for CML at the Department of Pediatrics, The Catholic University of...

Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children
You Jin Jung, Yeon Jin Jeon, Won Kyoung Cho, Jae Wook Lee, Nack-Gyun Chung, Min Ho Jung, Bin Cho, Byung-Kyu Suh
Clin Exp Pediatr. 2013;56(7):298-303.   Published online July 19, 2013
Purpose

The purpose of this study was to evaluate short-term thyroid dysfunction and related risk factors in pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood.

Methods

We studied 166 patients (100 boys and 66 girls) who underwent HSCT at the Catholic HSCT Center from January 2004 through December 2009. The mean age at HSCT was 10.0±4.8 years. Thyroid function of...

Case Report
Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome
Seung Min Song, Min Sung Cho, Seak Hee Oh, Kyung Mo Kim, Young Seo Park, Dae Yeon Kim, Sung Gyu Lee
Clin Exp Pediatr. 2013;56(5):224-226.   Published online May 28, 2013

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with...

Original Article
Immune reconstitution after allogeneic hematopoietic stem cell transplantation in children: a single institution study of 59 patients
Hyun O Kim, Hyun Jin Oh, Jae Wook Lee, Pil-Sang Jang, Nack-Gyun Chung, Bin Cho, Hack-Ki Kim
Clin Exp Pediatr. 2013;56(1):26-31.   Published online January 29, 2013
Purpose

Lymphocyte subset recovery is an important factor that determines the success of hematopoietic stem cell transplantation (HSCT). Temporal differences in the recovery of lymphocyte subsets and the factors influencing this recovery are important variables that affect a patient's post-transplant immune reconstitution, and therefore require investigation.

Methods

The time taken to achieve lymphocyte subset recovery and the factors influencing this recovery were investigated...

Review Article
Umbilical cord blood transplantation
Hong Hoe Koo, Hyo Seop Ahn
Clin Exp Pediatr. 2012;55(7):219-223.   Published online July 17, 2012

Since the first umbilical cord blood transplantation (CBT) in 1998, cord blood (CB) has now become one of the most commonly used sources of hematopoietic stem cells for transplantation. CBT has advantages of easy procurement, no risk to donor, low risk of transmitting infections, immediate availability and immune tolerance allowing successful transplantation despite human leukocyte antigen disparity. Several studies have...

Treatment of high-risk neuroblastoma
Ki Woong Sung
Clin Exp Pediatr. 2012;55(4):115-120.   Published online April 30, 2012

Although high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) have improved the prognosis for patients with high-risk neuroblastoma (NB), event-free survival rates remain in the range of 30 to 40%, which is unsatisfactory. To further improve outcomes, several clinical trials, including tandem HDCT/autoSCT, high-dose 131I-metaiodobenzylguanidine treatment, and immunotherapy with NB specific antibody, have been undertaken and pilot studies have reported...

Original Article
Outcome of allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission: a single institution study
Eun-Jung Lee, Ji Yoon Han, Jae Wook Lee, Pil-Sang Jang, Nack-Gyun Chung, Dae-Chul Jeong, Bin Cho, Hack-Ki Kim
Clin Exp Pediatr. 2012;55(3):100-106.   Published online March 16, 2012
Purpose

The survival rate for childhood acute lymphoblastic leukemia (ALL) has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete...

Hematopoietic stem cell transplantation in children with acute leukemia: similar outcomes in recipients of umbilical cord blood versus marrow or peripheral blood stem cells from related or unrelated donors
Eun Sang Yi, Soo Hyun Lee, Meong Hi Son, Ju Youn Kim, Eun Joo Cho, Su Jin Lim, Hee Won Cheuh, Keon Hee Yoo, Ki Woong Sung, Hong Hoe Koo
Clin Exp Pediatr. 2012;55(3):93-99.   Published online March 16, 2012
Purpose

This study compared outcomes in children with acute leukemia who underwent transplantations with umbilical cord blood (UCB), bone marrow, or peripheral blood stem cells from a human leukocyte antigen (HLA)-matched related donor (MRD) or an unrelated donor (URD).

Methods

This retrospective study included consecutive acute leukemia patients who underwent their first allogeneic hematopoietic stem cell transplantation (HSCT) at Samsung Medical Center between...

Review Article
Treatment of steroid-resistant pediatric nephrotic syndrome
Hee Gyung Kang
Clin Exp Pediatr. 2011;54(8):317-321.   Published online August 31, 2011

Children who suffer from steroid-resistant nephrotic syndrome (SRNS) require aggressive treatment to achieve remission. When intravenous high-dose methylprednisolone fails, calcineurin inhibitors, such as cyclosporine and tacrolimus, are used as the first line of treatment. A significant number of patients with SRNS progress to end-stage renal disease if remission is not achieved. For these children, renal replacement therapy can also be...

The treatment of pediatric chronic myelogenous leukemia in the imatinib era
Jae Wook Lee, Nack Gyun Chung
Clin Exp Pediatr. 2011;54(3):111-116.   Published online March 31, 2011

Childhood chronic myelogenous leukemia (CML) is a rare hematologic disease, with limited literature on the methods of treatment. Previously, allogeneic hematopoietic stem cell transplantation (HSCT) was considered the only curative treatment for this disease. Treatment with imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase (TKI), has resulted in prolonged molecular response with limited drug toxicity. Imatinib is now implemented...

Case Report
A case of tacrolimus-induced encephalopathy after kidney transplantation
Myoung Uk Kim, Sae Yoon Kim, Su Min Son, Yong Hoon Park
Clin Exp Pediatr. 2011;54(1):40-44.   Published online January 31, 2011

We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI) showed acute infarction of the middle cerebral artery (MCA) territory in the right frontal lobe. Three days...

Renal transplantation in a patient with Bartter syndrome and glomerulosclerosis
Se Eun Lee, Kyoung Hee Han, Yun Hye Jung, Hyun Kyung Lee, Hee Gyung Kang, Kyung Chul Moon, Il Soo Ha, Yong Choi, Hae Il Cheong
Clin Exp Pediatr. 2011;54(1):36-39.   Published online January 31, 2011

Bartter syndrome (BS) is a clinically and genetically heterogeneous inherited renal tube disorder characterized by renal salt wasting, hypokalemic metabolic alkalosis and normotensive hyperreninemic hyperaldosteronism. There have been several case reports of BS complicated by focal segmental glomerulosclerosis (FSGS). Here, we have reported the case of a BS patient who developed FSGS and subsequent end-stage renal disease (ESRD) and provided...

Original Article
Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients
Sang Jeong Kim, Dong Kyun Han, Hee Jo Baek, Dong Yeon Kim, Taek Keun Nam, Tai Ju Hwang, Hoon Kook
Clin Exp Pediatr. 2010;53(4):538-547.   Published online April 15, 2010
Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen,...
Endocrine dysfunction after bone marrow transplantation during childhood and adolescence
Hye Young Jin, Jin-Ho Choi, Ho-Joon Im, Jong-Jin Seo, Hyung-Nam Moon, Han-Wook Yoo
Clin Exp Pediatr. 2010;53(3):420-427.   Published online March 15, 2010
Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis,...
Review Article
Current status of pediatric kidney transplantation
Sung-Do Kim, Byoung-Soo Cho
Clin Exp Pediatr. 2009;52(10):1075-1081.   Published online October 15, 2009
Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on...
Brain death and organ transplantation
Sang-Ook Nam
Clin Exp Pediatr. 2009;52(8):856-861.   Published online August 15, 2009
Cardiopulmonary arrest has long been accepted as an unquestionable definition of death. An advent of cardiopulmonary resuscitation and artificial ventilation along with the development of organ transplantation has prompted the emergence of the concept of brain death. The criteria for brain death are based mainly on the clinical examination of coma, apnea and total loss of brain stem function. Although organ transplantation by...