Rejection with heart failure after pediatric cardiac transplantation

Flippin, Mindee J; Balzer, David T.; Murphy, Paula; Ruble, Susan; Mendeloff, Eric N.; Huddleston, Charles B.; Canter, Charles E.

doi:10.1016/s0003-4975(99)00476-2

Cited by 8 publications

(2 citation statements)

References 9 publications

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“…It is known that allograft rejection is a major cause of mortality and morbidity after thoracic transplantation in children. 11 Some studies have demonstrated that infant LTx grafts have lower rates of acute rejection and bronchiolitis obliterans. 12,13 A study of over 200 heart and LTxs demonstrated that age o1…”

Section: Discussionmentioning

confidence: 99%

Is lung transplantation survival better in infants? Analysis of over 80 infants

Khan¹,

Heinle²,

Samayoa³

et al. 2013

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

Is lung transplantation survival better in infants? Analysis of over 80 infants

Khan¹,

Heinle²,

Samayoa³

et al. 2013

The Journal of Heart and Lung Transplantation

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“…The development of late rejection has been linked to transplant coronary artery disease (TCAD) and poor outcome [11, 14, 16]. In the pediatric population, studies have demonstrated that heart transplant recipients with a history of previous rejection episodes are at higher risk for symptomatic or fatal rejection [5]. Additionally, in pediatric patients experiencing late rejection following a previous episode of rejection, severe hemodynamic compromise has been identified as a risk factor for death [3, 11].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Acute Graft Rejection Associated with Hemodynamic Compromise in Pediatric Heart Transplant Recipients

et al. 2010

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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, six-month graft survival in this group is low secondary to a high incidence of graft failure related to worsening or aggressive transplant coronary artery disease.

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