title: Chest radiography in infant cardiac allotransplantation.
abstract: Heart transplants were performed in seven infants at Loma Linda University Medical Center from 1985 to 1987. Five of these seven patients survived. In this report, the radiographic appearance of the chest is presented before surgery, immediately after surgery, and during a documented episode of rejection. The most current available chest radiograph is also presented. Acute rejection was confirmed by clinical, echocardiographic, and ECG findings. The only pulmonary infection encountered was mycoplasma pneumonitis. Four patients developed gastrointestinal rotavirus infections and were shown to have dilated proximal small-bowel folds on upper gastrointestinal studies. At the time of this writing, the prognosis for the five surviving infants is good. We conclude that the radiographs of infants who have received heart transplants show an unusual cardiac contour and slight cardiomegaly. Increasing cardiomegaly can alert one to early rejection. Prominent folds in the small bowel are of uncertain origin and significance, but they may be related to infection resulting from immunosuppression.
authors.affiliation: Department of Radiology, Loma Linda University Medical Center, CA 92354.
authors.forename: F B
authors.initials: FB
authors.lastname: Toomey
authors.forename: L L
authors.initials: LL
authors.lastname: Bailey
authors.forename: R D
authors.initials: RD
authors.lastname: Bui
authors.forename: M
authors.initials: M
authors.lastname: Kanahriyeh
authors.forename: E
authors.initials: E
authors.lastname: Petry
authors.forename: C
authors.initials: C
authors.lastname: Mathis
authors.forename: J
authors.initials: J
authors.lastname: Johnston
authors.forename: J
authors.initials: J
authors.lastname: Mace
authors.forename: B
authors.initials: B
authors.lastname: Grill
authors.forename: M
authors.initials: M
authors.lastname: Klooster
mesh_terms: D005260:Female; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging; D006084:Graft Rejection; D006321:Heart / Q000000981:diagnostic imaging; D016027:Heart Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D012400:Rotavirus Infections / Q000000981:diagnostic imaging