{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:04:22Z","timestamp":1753869862989,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence for aspirin efficacy testing in pediatrics is limited, especially outside of cardiology, yet thrombotic events have high morbidity in other areas such as pediatric transplant surgery. Debates about whether thromboembolic events while on aspirin represent \u201caspirin resistance\u201d or \u201chigh on\u2010treatment platelet reactivity\u201d persist, given the poor intertest agreement between testing platforms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>This prospective observational study involved measuring aspirin efficacy using <jats:italic>ex vivo<\/jats:italic> testing of platelet aggregation (VerifyNow\u2010Aspirin, VN) and urine 11\u2010dehydrothromboxane B2 (AsprinWorks, UTxB2) contemporaneously at up to three time points after major noncardiac organ transplant surgery. The collection days (CD) were the second and seventh days after stable aspirin dosing and then a convalescent time point 2\u20109 months later.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five participants (age range, 0\u201021 years) were enrolled, having undergone total pancreatectomy with islet autotransplantation (<jats:italic>N<\/jats:italic>\u00a0=\u00a036), orthotopic liver transplantation (<jats:italic>N<\/jats:italic>\u00a0=\u00a018), and combined liver\u2010kidney transplantation (<jats:italic>N<\/jats:italic>\u00a0=\u00a01). Platelet reactivity measured by VN remained unchanged, whereas UTxB2, which was elevated postoperatively, decreased significantly from CD1 to CD2 and CD3. Discordance in therapeutic efficacy was noted per manufacturer cutoffs, with therapeutic VN results in 86% of tests, whereas 12% of UTxB2 were therapeutic. Age\u2010based stratification of UTxB2 results using previously published pediatric median levels increased overall UTxB2 therapeutic rates (80%) and intertest concordance (67% vs 27% if using adult range). No thrombotic events were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data suggest that urine thromboxane production may be an underappreciated reflection of postoperative inflammation. Validation of pediatric normal ranges for UTxB2 is a critical next step.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29413","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T12:16:52Z","timestamp":1634905012000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Urinary 11\u2010dehydrothromboxane B2 aspirin efficacy testing is sensitive to perioperative inflammation in pediatric solid\u2010organ transplant patients"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5392-1829","authenticated-orcid":false,"given":"Alexander A.","family":"Boucher","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Hematology\/Oncology University of Minnesota Medical School  Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenton J.","family":"Francisco","sequence":"additional","affiliation":[{"name":"Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Martin","sequence":"additional","affiliation":[{"name":"Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"Martin","sequence":"additional","affiliation":[{"name":"Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Shova","sequence":"additional","affiliation":[{"name":"Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaimie D.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory M.","family":"Tiao","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori","family":"Luchtman\u2010Jones","sequence":"additional","affiliation":[{"name":"Cancer and Blood Diseases Institute Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27665"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2308"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm226"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.06.031"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.06.016"},{"volume-title":"R Foundation for Statistical Computing","year":"2019","key":"e_1_2_9_7_1"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21465"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25089"},{"key":"e_1_2_9_10_1","unstructured":"Food and Drug Administration US.510(k) Substantial equivalence determination decision summary assay only template (11\u2010dehydro thromboxane B2).2007;https:\/\/www.accessdata.fda.gov\/cdrh_docs\/reviews\/K062025.pdf. 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