{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:23:31Z","timestamp":1790630611461,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,30]],"date-time":"2018-12-30T00:00:00Z","timestamp":1546128000000},"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 Transplantation"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In this single\u2010center retrospective study, we analyzed kidney transplant outcomes in nine pediatric patients with VACTERL [vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, limb abnormalities] association\u2014making this the largest study of its kind. Of 743 pediatric kidney transplant recipients at our center (1980\u20102017), nine had documented diagnoses of VACTERL association. All nine had congenital anorectal malformations and renal anomalies, five had vertebral defects, and one had a bifid thumb and tracheoesophageal fistula. Renal anomalies included dysplasia (n\u00a0=\u00a06), aplasia (n\u00a0=\u00a03), and horseshoe kidney (n\u00a0=\u00a02). Congenital lower urinary tract anomalies included neurogenic bladder (n\u00a0=\u00a06), obstructive uropathy (n\u00a0=\u00a04), anovesicular fistula (n\u00a0=\u00a01), rectourethral fistula (n\u00a0=\u00a01), and posterior urethral valves (n\u00a0=\u00a01). Age at transplant ranged from 1.2 to 15\u00a0years (mean, 7.3; standard deviation [SD], 5.5); 6 (67%) were male, and 3 (33%) were female; 6 (67%) had a living related donor, and 3 (33%) had a deceased donor. The overall graft survival rate was 78% (range, 1.5 to 25.2\u00a0years; mean, 10.5; SD, 8.9). One month post\u2010transplant, one recipient died with a functioning graft. At 3.7\u00a0years post\u2010transplant, one graft failed because of recurrent pyelonephritis. Post\u2010transplant urologic complications included pyelonephritis (n\u00a0=\u00a06), vesicoureteral reflux (n\u00a0=\u00a05), and graft hydronephrosis (n\u00a0=\u00a04). We conclude that pediatric patients with VACTERL association can be safely transplanted\u2014careful patient selection with vigilance and intervention for pre\u2010 and post\u2010transplant urologic complications is essential.<\/jats:p>","DOI":"10.1111\/petr.13341","type":"journal-article","created":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T22:38:02Z","timestamp":1546295882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes of kidney transplants in pediatric patients with the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, limb abnormalities association"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-3259","authenticated-orcid":false,"given":"Jessica","family":"Diaz","sequence":"first","affiliation":[{"name":"University of Minnesota Medical School Minneapolis Minnesota"},{"name":"Fairview Perioperative Services Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanche","family":"Chavers","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5443-1258","authenticated-orcid":false,"given":"Srinath","family":"Chinnakotla","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8836-0881","authenticated-orcid":false,"given":"Priya","family":"Verghese","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics University of Minnesota Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(73)80024-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(74)80113-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-012-3100-z"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-012-3073-y"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1159\/000345300","article-title":"VATER\/VACTERL association: evidence for the role of genetic factors","volume":"4","author":"Reutter H","year":"2013","journal-title":"Mol Syndromol"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2013.58"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-6-56"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19960628)63:4<529::AID-AJMG4>3.0.CO;2-J"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19970711)71:1<8::AID-AJMG2>3.0.CO;2-V"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.10371"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-008-1101-x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2011.03.079"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2014-208784"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-010-2688-0"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008030287"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2004.tb00392.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.12.027"},{"key":"e_1_2_8_19_1","first-page":"203","volume-title":"Clin Transplant 1994","author":"Chavers BM","year":"1995"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ac6833"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.01912.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.09.005"},{"key":"e_1_2_8_23_1","first-page":"674","article-title":"Kidney transplant in pediatric patients with severe bladder pathology","volume":"19","author":"Sierralta MC","year":"2017","journal-title":"Pediatr Transplant"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)62119-0"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/TP.0b013e318204381a","article-title":"Pediatric kidney recipients with small capacity, defunctionalized urinary bladders receiving adult\u2010sized kidney without prior bladder augmentation","volume":"91","author":"Alexopoulos S","year":"2011","journal-title":"Transplantation"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.03.040"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(02)02869-5"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.09.094"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.049"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.07096.x"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1234114"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12919"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1608-x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005040439"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpetr.13341","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.13341","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T03:39:29Z","timestamp":1694662769000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.13341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,30]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1111\/petr.13341"],"URL":"https:\/\/doi.org\/10.1111\/petr.13341","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,30]]},"assertion":[{"value":"2018-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13341"}}