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183 results on '"Vargas, Jorge H."'

2. Endoscopy Following Pediatric Intestinal Transplant

Author

Yeh, Joanna, Ngo, Khiet D, Wozniak, Laura J, Vargas, Jorge H, Marcus, Elizabeth A, McDiarmid, Sue V, Farmer, Douglas G, and Venick, Robert S

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Autoimmune Disease, Organ Transplantation, Digestive Diseases, Transplantation, Oral and gastrointestinal, Adolescent, Biopsy, Child, Child, Preschool, Endoscopy, Gastrointestinal, Female, Graft Rejection, Humans, Infant, Intestines, Male, Retrospective Studies, colonoscopy, enteroscopy, ileoscopy, intestinal transplant, pediatric endoscopy, Medical and Health Sciences, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics, Paediatrics
Abstract

ObjectivesBiopsies remain the criterion standard in the diagnosis of intestinal transplant (ITx) rejection, and gastrointestinal endoscopy plays a pivotal role in patient management. Herein, we describe a single-center 23-year endoscopic experience in pediatric ITx recipients.MethodsA retrospective review of endoscopy and pathology reports of all ITx recipients

Published
2015

3. Donor-specific HLA Antibodies Are Associated With Late Allograft Dysfunction After Pediatric Liver Transplantation

Author

Wozniak, Laura J, Hickey, Michelle J, Venick, Robert S, Vargas, Jorge H, Farmer, Douglas G, Busuttil, Ronald W, McDiarmid, Sue V, and Reed, Elaine F

Subjects
Biomedical and Clinical Sciences, Immunology, Transplantation, Organ Transplantation, Liver Disease, Pediatric, Chronic Liver Disease and Cirrhosis, Digestive Diseases, Clinical Research, 2.1 Biological and endogenous factors, Good Health and Well Being, Acute Disease, Adolescent, Age Factors, Biomarkers, Chi-Square Distribution, Child, Child, Preschool, Chronic Disease, Complement C1q, Cross-Sectional Studies, Female, Graft Rejection, Graft Survival, HLA Antigens, HLA-DQ Antigens, Hepatitis, Autoimmune, Histocompatibility, Histocompatibility Testing, Humans, Immunosuppressive Agents, Infant, Infant, Newborn, Isoantibodies, Liver Transplantation, Logistic Models, Male, Multivariate Analysis, Odds Ratio, Phenotype, Risk Factors, Tacrolimus, Time Factors, Transplantation Tolerance, Treatment Outcome, Young Adult, Medical and Health Sciences, Surgery, Clinical sciences
Abstract

BackgroundThe role of donor-specific HLA antibodies (DSA) after pediatric liver transplantation (LTx) is not clearly established. We completed a cross-sectional study to characterize DSA in long-term survivors of pediatric LTx and assess the impact of C1q-binding DSA on allograft outcomes.MethodsSerum samples were collected at routine clinic visits from 50 pediatric LTx recipients classified into 3 clinical phenotypes: nontolerant (n = 18) with de novo autoimmune hepatitis (DAIH) and/or late acute cellular rejection (ACR); stable (n = 25) on maintenance tacrolimus; operationally tolerant (n = 7). Samples were blinded, and antibody detection was performed using Luminex single antigen class I and II beads. Patients with positive DSA were tested for C1q-binding DSA.ResultsDSA were detected in 54% (n = 27) of the patients, with the majority directed at HLA class II antigens (DR, 41%; DQ, 53%). Patients with DSA were younger at the time of LTx (P = 0.016) and time of study (P = 0.024). Mean aspartate aminotransferase, alanine aminotransferase, total bilirubin, and gamma glutamyl transferase were higher in DSA-positive patients, though did not reach statistical significance. Nontolerant patients were significantly more likely to have DQ DSA (61%) compared to stable (20%) and tolerant (29%) patients (P = 0.021). The nontolerant phenotype was associated with DSA and C1q-binding DSA, with odds ratios of 13 (P = 0.015) and 8.6 (P = 0.006), respectively. The presence of DQ DSA was associated with DAIH and late ACR, with odds ratios of 12.5 (P = 0.004) and 10.8 (P = 0.006), respectively.ConclusionsAllograft dysfunction is not always evident in patients with DSA, but DQ DSA are strongly associated with DAIH, late ACR, and chronic rejection.

Published
2015

7. Operational tolerance is not always permanent: A 10‐year prospective study in pediatric liver transplantation recipients

Author

Wozniak, Laura J., primary, Venick, Robert S., additional, Naini, Bita V., additional, Scapa, Jason, additional, Hickey, Michelle J., additional, Rossetti, Maura, additional, Korin, Yael, additional, Reed, Elaine F., additional, Farmer, Douglas G., additional, Busuttil, Ronald W., additional, Vargas, Jorge H., additional, and McDiarmid, Sue V., additional

Published
2022
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10. Mutant neurogenin-3 in congenital malabsorptive diarrhea

Author

Jiafang Wang, Cortina, Galen, Wu, S. Vincent, Tran, Robert, Jang-Hyeon Cho, Ming-Jer Tsai, Bailey, Travis J., Jamrich, Milan, Ament, Marvin E., Treem, William R., Hill, Ivor D., Vargas, Jorge H., Gershman, George, Farmer, Douglas G., Reyen, Laurie, and Martin, Martin G.

Subjects
Diarrhea -- Genetic aspects, Gene mutations -- Research, Genetic disorders -- Genetic aspects
Abstract

The genomic DNA from three unrelated patients with sparse enteroendocrine cells are screened for mutations of neurogenin-3 (NEUROG3) and then the ability of the observed mutations to alter NEUROG3 function is tested using in vitro and in vivo assays. Loss-of-function mutations in NEUROG3 causes a disorder characterized by malabsorptive diarrhea and a lack of intestinal enteroendocrine cells.

Published
2006

16. Toddler suffers from emesis and weight loss

Author

Bekmezian, Arpi, Vargas, Jorge H., Ament, Marvin E., and Venick, Robert

Subjects
Achalasia -- Diagnosis, Achalasia -- Care and treatment, Achalasia -- Case studies, Achalasia -- Demographic aspects, Vomiting -- Causes of, Weight loss -- Causes of
Published
2010

17. Mutant Neurogenin-3 in Congenital Malabsorptive Diarrhea

Author

Wang, Jiafang, Cortina, Galen, Wu, S. Vincent, Tran, Robert, Cho, Jang-Hyeon, Tsai, Ming-Jer, Bailey, Travis J., Jamrich, Milan, Ament, Marvin E., Treem, William R., Hill, Ivor D., Vargas, Jorge H., Gershman, George, Farmer, Douglas G., Reyen, Laurie, and Martin, Martin G.

Published
2006

23. Obliterative portal venopathy: A histopathologic finding associated with chronic antibody-mediated rejection in pediatric liver allografts

Author

Guerra, Marjorie-Anne R., primary, Naini, Bita V., additional, Scapa, Jason V., additional, Reed, Elaine F., additional, Busuttil, Ronald W., additional, Cheng, Elaine Y., additional, Farmer, Douglas G., additional, Vargas, Jorge H., additional, Venick, Robert S., additional, McDiarmid, Sue V., additional, and Wozniak, Laura J., additional

Published
2018
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25. Endoscopy Following Pediatric Intestinal Transplant: A 23 Year Single Center Experience

Author

Yeh, Joanna, Ngo, Khiet D., Wozniak, Laura J., Vargas, Jorge H., Marcus, Elizabeth A., McDiarmid, Sue V., Farmer, Douglas G., and Venick, Robert S.

Subjects
Graft Rejection, Male, Adolescent, Biopsy, Infant, Organ Transplantation, Article, Endoscopy, Gastrointestinal, Intestines, Child, Preschool, Humans, Female, Child, Retrospective Studies
Abstract

Biopsies remain the criterion standard in the diagnosis of intestinal transplant (ITx) rejection, and gastrointestinal endoscopy plays a pivotal role in patient management. Herein, we describe a single-center 23-year endoscopic experience in pediatric ITx recipients.A retrospective review of endoscopy and pathology reports of all ITx recipients18 years old transplanted between 1991 and 2013 was performed with the aim of describing the procedural indications, findings, and complications.A total of 1770 endoscopic procedures within 1014 sessions were performed. A combination of esophagogastroduodenoscopy and ileoscopy was the most common procedure (36%). Increased stool output (35%) and surveillance endoscopy (32%) were the most common indications. A total of 162 episodes of biopsy-proven rejection were diagnosed. The first episode of rejection occurred at a median of 1 month after ITx. Of histology-proven rejections, 45% had normal-appearing endoscopies. The rate of procedural complications, including but not limited to bleeding and perforation, was 1.8%.Endoscopy with biopsy plays a significant role in the care of ITx recipients. Multiple procedures are required for graft surveillance, diagnosis of rejection, subsequent treatment, and follow-up of therapy. The gross endoscopic appearance, particularly in mild to moderate acute cellular rejection, does not correlate well with histology. Complex anatomy, complication rates that are higher than patients with non-ITx pediatric endoscopy, and timely histologic interpretation by experienced pathologists are reasons that these procedures should be performed at centers accustomed to caring for ITx recipients. The field would benefit from the development of a noninvasive biomarker to reliably and efficiently detect rejection.

Published
2015

26. Acute antibody-mediated rejection in ABO-compatible pediatric liver transplant recipients: case series and review of the literature

Author

Wozniak, Laura J., primary, Naini, Bita V., additional, Hickey, Michelle J., additional, Bhattacharyya, Sarathi, additional, Reed, Elaine F., additional, Busuttil, Ronald W., additional, Farmer, Douglas G., additional, Vargas, Jorge H., additional, Venick, Robert S., additional, and McDiarmid, Sue V., additional

Published
2016
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27. Epidemiology and Risk Factors for Outpatient-Acquired Catheter-Related Bloodstream Infections in Children Receiving Home Parenteral Nutrition.

Author

Wozniak, Laura J., Bechtold, Hannah M., Reyen, Laurie E., Chan, Alvin P., Marcus, Elizabeth A., and Vargas, Jorge H.

Subjects
CATHETER-related infections, PARENTERAL feeding, PATIENT nutrition, EPIDEMIOLOGY, GASTROINTESTINAL diseases, RESPIRATORY diseases
Abstract

Background: Few studies have examined the epidemiology and risk factors for the development of outpatient-acquired catheter-related bloodstream infections (CRBSIs) in children receiving home parenteral nutrition. This study aimed to (1) characterize the incidence, clinical presentation, and epidemiology of CRBSIs and (2) identify risk factors for CRBSIs in children receiving home parenteral nutrition.Methods: A longitudinal database approved by our Institutional Review Board was created to prospectively track CRBSIs in the UCLA pediatric population from January to December 2012. Eligible patients included those < 18 years old receiving home parenteral nutrition.Results: Thirty of 60 patients (50%) were diagnosed with 66 CRBSIs, for an overall CRBSI rate of 3.6 per 1000 catheter days. Of the CRBSIs, 73% were due to single microorganisms and 27% were polymicrobial. There was a significant difference in median (range) time for blood cultures to turn positive depending on type of CRBSIs (p = 0.03), with polymicrobial infections detected at 13.4 (8.7-24.3) hours, gram-negative infections at 16.5 (9-30.8) hours, and gram-positive infections at 18.9 (8.4-37.1) hours. The most common presenting symptom was fever (82%), followed by gastrointestinal symptoms (42%) and chills (29%). The only significant multivariate risk factor for CRBSIs was presence of a feeding tube (2.3-fold increase in CRBSI risk, p = 0.04).Discussion: Outpatient-acquired CRBSIs are common in children receiving home parenteral nutrition. CRBSIs typically present with fever, but are also associated with gastrointestinal and/or respiratory symptoms. The presence of feeding tubes may predispose children on home parenteral nutrition to developing CRBSIs. [ABSTRACT FROM AUTHOR]

Published
2018
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30. Long-Term Nutrition and Predictors of Growth and Weight Gain Following Pediatric Intestinal Transplantation

Author

Venick, Robert S., primary, Wozniak, Laura J., additional, Colangelo, Joanie, additional, Beckwith, Patty, additional, Reyen, Laurie, additional, Esmailian, Yvonne A., additional, McDiarmid, Sue V., additional, Vargas, Jorge H., additional, Ament, Marvin E., additional, Busuttil, Ronald W., additional, and Farmer, Douglas G., additional

Published
2011
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39. ORTHOTOPIC LIVER TRANSPLANTATION FOR AUTOIMMUNE HEPATITIS AND CRYPTOGENIC CHRONIC HEPATITIS IN CHILDREN1

Author

Bahar, Ron J., primary, Yanni, George S., additional, Martin, Mart??n G., additional, McDiarmid, Sue V., additional, Vargas, Jorge H., additional, Gershman, George B., additional, Heyman, Melvin B., additional, Rosenthal, Philip, additional, Tipton, James R., additional, Nanjundiah, Prathiba, additional, Starr, Amy, additional, and Ament, Marvin E., additional

Published
2001
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50. Toddler suffers from emesis and weight loss.

Author

BEKMIZIAN, ARPI, VARGAS, JORGE H., AMENT, MARVIN E., and VENICK, ROBERT

Subjects
VOMITING, COUGH, GASTROESOPHAGEAL reflux in children, MILK proteins
Abstract

The article describes the case of a 13-month-old girl who was admitted to the emergency department for failure to thrive due to vomiting and cough. The medical history of the patient is presented. Findings from physical examination are given. Further diagnosis include gastroesophageal reflux disease (GERD), possible structural lesions and milk protein intolerance.

Published
2010

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