Pediatric Grand Rounds (RECORDING) Outcomes of Pediatric Liver Transplantation 2023 – Something for Everyone to Care About

This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice.  In this session, Dr. Vicky Ng will discuss outcomes of pediatric liver transplantation in 2023, including how to recognize the 5W’s of pediatric liver transplantation, highlighting current issues affecting the health status of long-term survivors of pediatric liver transplantation and illustrating the broader determinants of health in survivors of pediatric liver transplantation. therapies.

  Release Date: June 30, 2023
  Expiration Date: June 29, 2024
  Estimated Time to Complete: 1.0 hour
  Registration Fee: FREE
 *Originally recorded 05/19/2023.

1. Recognize the 5W’s of pediatric liver transplantation.
2. Examine current issues affecting the health status of long-term survivors of pediatric liver transplantation.
3. Discuss the broader determinants of health in survivors of pediatric liver transplantation.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accessibility Statement
 Stanford University School of Medicine is committed to ensuring that its programs, services, goods and facilities are accessible to individuals with disabilities as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Amendments Act of 2008.  If you have needs that require accommodations, please contact the CME Conference Coordinator.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography

Applied Health Research Centre. (2023). Pediatric Total Psoas Muscle Area (tPMA) z-score 
Calculator. Applied Health Research Centre, SickKids. https://app-test-env.shinyapps.io/sarcopenia_final/

Black N. (2013). Patient reported outcome measures could help transform healthcare. BMJ 
(Clinical research ed.), 346, f167. https://doi.org/10.1136/bmj.f167

Bucuvalas, J. C., Alonso, E., Magee, J. C., Talwalkar, J., Hanto, D., & Doo, E. (2008). 
Improving long-term outcomes after liver transplantation in children. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 8(12), 2506–2513. https://doi.org/10.1111/j.1600-6143.2008.02432.x

Carey, E. J., Lai, J. C., Sonnenday, C., Tapper, E. B., Tandon, P., Duarte-Rojo, A., Dunn, M. A., 
Tsien, C., Kallwitz, E. R., Ng, V., Dasarathy, S., Kappus, M., Bashir, M. R., & Montano-Loza, A. J. (2019). A North American Expert Opinion Statement on Sarcopenia in Liver Transplantation. Hepatology (Baltimore, Md.), 70(5), 1816–1829. https://doi.org/10.1002/hep.30828

Elisofon, S. A., Magee, J. C., Ng, V. L., Horslen, S. P., Fioravanti, V., Economides, J., Erinjeri, 
J., Anand, R., Mazariegos, G. V., & Society of Pediatric Liver Transplantation Research Group (2020). Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatric transplantation, 24(1), e13605. https://doi.org/10.1111/petr.13605

Feng, S., Bucuvalas, J. C., Demetris, A. J., Burrell, B. E., Spain, K. M., Kanaparthi, S., Magee, J. 
C., Ikle, D., Lesniak, A., Lozano, J. J., Alonso, E. M., Bray, R. A., Bridges, N. E., Doo, E., Gebel, H. M., Gupta, N. A., Himes, R. W., Jackson, A. M., Lobritto, S. J., Mazariegos, G. V., … Sanchez-Fueyo, A. (2018). Evidence of Chronic Allograft Injury in Liver Biopsies From Long-term Pediatric Recipients of Liver Transplants. Gastroenterology, 155(6), 1838–1851.e7. https://doi.org/10.1053/j.gastro.2018.08.023

Feng, S., Bucuvalas, J. C., Mazariegos, G. V., Magee, J. C., Sanchez-Fueyo, A., Spain, K. M., 
Lesniak, A., Kanaparthi, S., Perito, E., Venkat, V. L., Burrell, B. E., Alonso, E. M., Bridges, N. D., Doo, E., Gupta, N. A., Himes, R. W., Ikle, D., Jackson, A. M., Lobritto, S. J., Jose Lozano, J., … Demetris, A. J. (2021). Efficacy and Safety of Immunosuppression Withdrawal in Pediatric Liver Transplant Recipients: Moving Toward Personalized Management. Hepatology (Baltimore, Md.), 73(5), 1985–2004. https://doi.org/10.1002/hep.31520

Fisher R. A. (2019). Anonymous live liver donor: the Good Samaritan Stranger. Nature reviews. 
Gastroenterology & hepatology, 16(11), 650–651. https://doi.org/10.1038/s41575-019-0207-x

Foster, B. J., Dahhou, M., Zhang, X., Dharnidharka, V. R., Conway, J., & Ng, V. L. (2016). High 
Risk of Liver Allograft Failure During Late Adolescence and Young Adulthood. Transplantation, 100(3), 577–584. https://doi.org/10.1097/TP.0000000000001009

Ju, A., Cazzolli, R., Howell, M., Scholes-Robertson, N., Wong, G., & Jaure, A. (2023). Novel 
Endpoints in Solid Organ Transplantation: Targeting Patient-reported Outcome Measures. Transplantation, 10.1097/TP.0000000000004537. Advance online publication. https://doi.org/10.1097/TP.0000000000004537

Kehar, M., Parekh, R. S., Stunguris, J., De Angelis, M., Van Roestel, K., Ghanekar, A., Cattral, 
M., Fecteau, A., Ling, S., Kamath, B. M., Jones, N., Avitzur, Y., Grant, D., & Ng, V. L. (2019). Superior Outcomes and Reduced Wait Times in Pediatric Recipients of Living Donor Liver Transplantation. Transplantation direct, 5(3), e430. https://doi.org/10.1097/TXD.0000000000000865

Kelly, D. A., Bucuvalas, J. C., Alonso, E. M., Karpen, S. J., Allen, U., Green, M., Farmer, D., 
Shemesh, E., McDonald, R. A., American Association for the Study of Liver Diseases, & American Society of Transplantation (2013). Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 19(8), 798–825. https://doi.org/10.1002/lt.23697

Kwong, A. J., Kim, W. R., Lake, J. R., Smith, J. M., Schladt, D. P., Skeans, M. A., Noreen, S. 
M., Foutz, J., Booker, S. E., Cafarella, M., Snyder, J. J., Israni, A. K., & Kasiske, B. L. (2021). OPTN/SRTR 2019 Annual Data Report: Liver. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 21 Suppl 2, 208–315. https://doi.org/10.1111/ajt.16494

Lurz, E., Patel, H., Lebovic, G., Quammie, C., Woolfson, J. P., Perez, M., Ricciuto, A., Wales, P. 
W., Kamath, B. M., Chavhan, G. B., Jüni, P., & Ng, V. L. (2020). Paediatric reference values for total psoas muscle area. Journal of cachexia, sarcopenia and muscle, 11(2), 405–414. https://doi.org/10.1002/jcsm.12514

McElroy, L. M., Martin, A. E., Feldman, A. G., Ng, V. L., Kato, T., Reichman, T., Valentino, P. 
L., Anand, R., Anderson, S. G., Sudan, D. L., & Society of Pediatric Liver Transplantation (SPLIT) Research Committee (2023). An appraisal of technical variant grafts compared to whole liver grafts in pediatric liver transplant recipients: Multicenter analysis from the SPLIT registry. Pediatric transplantation, 27(1), e14415. https://doi.org/10.1111/petr.14415

Ng, V. L., Fecteau, A., Shepherd, R., Magee, J., Bucuvalas, J., Alonso, E., McDiarmid, S., 
Cohen, G., Anand, R., & Studies of Pediatric Liver Transplantation Research Group (2008). Outcomes of 5-year survivors of pediatric liver transplantation: report on 461 children from a north american multicenter registry. Pediatrics, 122(6), e1128–e1135. https://doi.org/10.1542/peds.2008-1363

Ng, V. L., Mazariegos, G. V., Kelly, B., Horslen, S., McDiarmid, S. V., Magee, J. C., Loomes, 
K. M., Fischer, R. T., Sundaram, S. S., Lai, J. C., Te, H. S., & Bucuvalas, J. C. (2019). Barriers to ideal outcomes after pediatric liver transplantation. Pediatric transplantation, 23(6), e13537. https://doi.org/10.1111/petr.13537

Ng, V., Nicholas, D., Dhawan, A., Yazigi, N., Ee, L., Stormon, M., Gilmour, S., Schreiber, R., 
Taylor, R., Otley, A., & PeLTQL study group (2014). Development and validation of the pediatric liver transplantation quality of life: a disease-specific quality of life measure for pediatric liver transplant recipients. The Journal of pediatrics, 165(3), 547–55.e7. https://doi.org/10.1016/j.jpeds.2014.05.024

Selvanathan, C., Famure, O., Batoy, B., Cocco, A., So, S., Breckbill, K., Meliton, G., Norgate, 
A., Kim, S. J., & Ng, V. L. (2021). Engaging high school students about organ donation and transplantation: an evaluation of the High School Outreach Initiative (HSOI) program. Pediatric transplantation, 25(4), e13981. https://doi.org/10.1111/petr.13981

de Ville de Goyet, J., Baumann, U., Karam, V., Adam, R., Nadalin, S., Heaton, N., Reding, R., 
Branchereau, S., Mirza, D., Klempnauer, J. L., Fischer, L., Kalicinski, P., Colledan, M., Lopez Santamaria, M., de Kleine, R. H., Chardot, C., Yilmaz, S., Kilic, M., Boillot, O., di Francesco, F., … European Liver, Intestine Transplant Association (2022). European Liver Transplant Registry: Donor and transplant surgery aspects of 16,641 liver transplantations in children. Hepatology (Baltimore, Md.), 75(3), 634–645. https://doi.org/10.1002/hep.32223

Wood, K. J., & Goto, R. (2012). Mechanisms of rejection: current perspectives. Transplantation, 
93(1), 1–10. https://doi.org/10.1097/TP.0b013e31823cab44

Wright, L., Ross, K., Abbey, S., Levy, G., & Grant, D. (2007). Living anonymous liver donation: 
case report and ethical justification. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 7(4), 1032–1035. https://doi.org/10.1111/j.1600-6143.2006.01725.x

For CME general questions, please contact 
     Email: [email protected]

Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Alan R. Schroeder, MD
Clinical Professor
Stanford University

Co-Course Director

Olivera Marsenic Couloures, MD
LPCH

Course Director and Reviewer

Nothing to disclose

Victoria Ng, PharmD
Cedar Sinai Medical Center

Faculty

Debra Babcock, MD
Stanford Childrens (PCHA)

Planner

Nothing to disclose

Lisa Jo Chamberlain, MD
Professor of Pediatrics – General Pediatrics
Stanford Children's Health

Planner

Baraka Dechelle Floyd, MD
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine

Planner

Nothing to disclose

Charles Gawad, MD, PhD
Associate Professor
Stanford

Planner

Allison Guerin, EdD
Stanford

Planner

Nothing to disclose

Mary Beth Leonard, MD, MSCE, MSCE
Arline and Pete Harman Professor and Chair, Department of Pediatrics
Stanford School of Medicine

Planner

Nothing to disclose

Ryan Lion, MD, MS
Stanford University

Planner

Nothing to disclose

Lauren E. E O'Brien, MD
Clinical Assistant Professor
LPCH

Planner

Nothing to disclose

Stephen J Roth, MPH, MD
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford

Planner

Nothing to disclose

Stephanie Squires, MD
Pediatric Hospital Medicine Fellow
Stanford Health Care/ Stanford Children's Hospital

Planner

Nothing to disclose

Ke-You Zhang, MD
Stanford University

Planner

Nothing to disclose