[Cardiac retransplantation: is it justified in childhood?].
A 7-year-old boy had undergone heart transplantation (HT) at 1 year of age. The immunosuppressive regimen consisted of cyclosporine and azathioprine (Cy+Aza). During the follow-up there were 7 episodes of moderate rejection: 4 of them occurred during the first 3 months. He had cytomegalovirus (CMV) seroconversion 4 years after HT. After 5 years since he underwent primary HT, cardiac catheterization and selective coronary angiography, performed on a yearly basis, showed triple vessel occlusive disease. The treadmill test was positive. During the following year, the patient's clinical condition deteriorated: in May '92 he underwent retransplantation. Cross-match was negative and there were no common HLA-DR antigens between the first and the second donor heart. Only 1 rejection episode occurred during the first 18 months of follow-up. Despite the shortage of donor hearts we feel that retransplantation is justified as an elective procedure in pediatric patients with cardiac allograft vasculopathy (CAV).
Cicini
M P
MP
Dipartimento Medico-Chirurgico di Cardiologia Pediatrica, Ospedale Bambino Gesù, Roma.
Parisi
F
F
Bevilacqua
M
M
Marcelletti
C
C
D001706:Biopsy; D006328:Cardiac Catheterization; D002648:Child; D017558:Elective Surgical Procedures; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000601:surgery; D016027:Heart Transplantation / Q000276:immunology / Q000473:pathology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D008297:Male; D009206:Myocardium / Q000473:pathology; D012086:Reoperation
Ritrapianto cardiaco: è giustificato in età pediatrica?