Neonatal cardiac transplantation. Intermediate-term results and incidence of rejection. Loma Linda University Pediatric Heart Transplant Group.
Early age at cardiac transplantation may favor successful engrafting with minimal chronic immunosuppression. Fifty-two newborns underwent orthotopic heart transplantation; 47 (90%) survived the operation, and 44 (85%) were late survivors. Actuarial survival was 92% at 1 month, 86% at 1 year, and 84% at 5 years. Forty-four infants who survived 12 weeks and the corresponding 100 rejection episodes were analyzed. Mean follow-up was 2.2 years. The mean number of rejections per year of follow-up was 1.2. No episodes of rejection were identified in six patients. Seven patients had a late rejection episode more than 1 year after transplantation, and only one had a late rejection episode after 2 years. Neonatal cardiac transplantation is effective and durable therapy for uncorrectable heart disease. Intermediate-term results are excellent. Severe rejection is uncommon, and few episodes occur after 1 year of follow-up.
Chiavarelli
M
M
Department of Surgery, Loma Linda International Heart Institute, CA.
Boucek
M M
MM
Nehlsen-Cannarella
S L
SL
Gundry
S R
SR
Razzouk
A J
AJ
Bailey
L L
LL
D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D002423:Cause of Death; D016001:Confidence Intervals; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006330:Heart Defects, Congenital / Q000601:surgery; D016027:Heart Transplantation / Q000379:methods; D006801:Humans; D007165:Immunosuppression Therapy; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D015996:Survival Rate; D013997:Time Factors
D016572:Cyclosporine; D001379:Azathioprine