Outcome of Acute Graft Rejection Associated with Hemodynamic Compromise in Pediatric Heart Transplant Recipients
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Christina M. Phelps • Cecile Tissot • Shannon Buckvold • Jane Gralla • D. Dunbar Ivy • Biagio A. Pietra • Shelley D. Miyamoto
- چاپ و سال / کشور: 2011
Description
We sought to analyze the outcome of hemodynamically significant acute graft rejection in pediatric heart transplant recipients from a single-center experience. Acute graft rejection remains a major cause of morbidity and mortality for patients who undergo orthotopic heart transplantation and has been associated with the severity of the rejection episode. A retrospective review of all children experiencing a hemodynamically significant rejection episode after orthotopic heart transplantation was performed. Fifty-three patients with 54 grafts had 70 rejection episodes requiring intravenous inotropic support. Forty-one percent of these patients required high-dose inotropic support, with the remaining 59% of patients requiring less inotropic support. Overall graft survival to hospital discharge was 41% for patients in the high-dose group compared to 94% in the low-dose group. Six-month graft survival in patients who required high-dose inotropes remained at 41% compared to 44% in the low-dose group. Hemodynamically significant acute graft rejection in pediatric heart transplant recipients is a devastating problem with poor short- and long-term outcomes. Survival to hospital discharge is dismal in patients who require high-dose inotropic support. In contrast, survival to discharge is quite good in patients who require only low-dose inotropic support; however, sixmonth graft survival in this group is low secondary to a high incidence of graft failure related to worsening or aggressive transplant coronary artery disease.
Pediatr Cardiol (2011) 32:1–7 DOI 10.1007/s00246-010-9795-5 Received: 26 March 2010 / Accepted: 18 September 2010 / Published online: 21 October 2010
