[Neonatal heart transplantation. First results].
Two 5- and 17-days old neonates with hypoplastic left heart syndrome respectively underwent orthotopic heart transplantation. The donor-recipient weight ratio was +58 percent and +88 percent; ischemic time was 144 and 167 min. The immunosuppressive protocol included thymoglobulin during the induction period and a classical 3-drug therapy, with a rapid tapering off of prednisone over 3 weeks. No infectious complication was observed; each infant experimented one episode of acute rejection, successfully treated with prednisolone. Forty-three months and 10 months later, the 2 children are doing well, with normal renal function and normal growth. No late rejection episode was observed. Heart transplantation in neonates is feasible, the short-term and mid-term results are good. Despite important ethical problems, heart transplantation represents a great hope for neonates with inoperable congenital heart defects.
Houyel
L
L
Centre Chirurgical Marie-Lannelongue, Université Paris-Sud, France.
Petit
J
J
Losay
J
J
Touchot-Kone
A
A
Bruniaux
J
J
Blaysat
G
G
Morville
P
P
Serraf
A
A
Lacour-Gayet
F
F
Planché
C
C
D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology; D006330:Heart Defects, Congenital / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D011239:Prednisolone / Q000627:therapeutic use
D011239:Prednisolone
Transplantation cardiaque néonatale. Premiers résultats.