Heart transplantation in children. Indications and outcomes.

被引:0
|
作者
Le Bidois, J [1 ]
Vouhe, P [1 ]
Tamisier, D [1 ]
Sidi, D [1 ]
Kachaner, J [1 ]
机构
[1] Hop Necker Enfants Malad, Serv CArdiol Pediat, F-75015 Paris, France
来源
ANNALES DE PEDIATRIE | 1998年 / 45卷 / 09期
关键词
heart transplantation;
D O I
暂无
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
To date, 92 heart transplants have been performed as part of the pediatric heart transplant program started at the Necker Enfants Malades/Laennec Hospital in Paris in 1987. One-third of patients were younger than two years of age at transplantation, and nine were younger than nine months. The most common reason for transplantation was cardiomyopathy (64%), which was usually of the dilated hypokinetic type; 33 patients (36%) had congenital heart defects. Maintenance immunosuppressant therapy usually consisted of cyclosporin and azathioprine, with in some cases Low-dose corticosteroid therapy. The postoperative complication rate was high. The most common early complication was acute rejection, whose diagnosis relied primarily on endomyocardial biopsy. Infections were.-very common during the first six months; after a phase of dominant bacterial infections, viral infections became more common. Cyclosporin caused renal dysfunction in some cases. Immunosuppressant-induced lymphoproliferative disorders occurred in eight patients and were severe in five. The main long-term complication was coronary artery disease, which was responsible for complete coronary artery occlusion in some cases. Mortality rates were about 22% during the first month and 26% subsequently. Most late deaths were due to coronary artery disease, rejection, or lymphoproliferative syndrome. Most survivors enjoyed an excellent quality of life and were able to engage in normal physical activities.
引用
收藏
页码:673 / 676
页数:4
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