Posttransplantation management of the newborn and the immunosuppressive role of prostaglandin E1.
Prostaglandin (PGE1) is used routinely in newborn infants with heart lesions to maintain patency of the ductus arteriosus. PGE1 has also been shown to have immunosuppressive effects. We used PGE1 postoperatively in 10 consecutively transplanted infants and prospectively assessed the frequency and severity of rejection episodes for 1 year after heart transplantation compared with the 10 consecutive, most recently transplanted infants who had not received PGE1 after transplantation. The PGE1-treated group was older (30 +/- 16 days) compared with 17 +/- 9 days for control subjects at the time of transplantation (mean +/- SD, p < 0.05). There was no difference between the two groups in weight (p > 0.05) or other modes of therapy. There was no correlation between the degree of tissue match and the incidence or severity of rejection. The diagnosis of rejection was based on clinical suspicion, supported by electrocardiographic and echocardiographic changes, and confirmed by a positive response to antirejection therapy and/or biopsy. Rejection was scored 0 through 3 according to severity. Rejection was significantly less severe and less frequent in the (PGE1) group by Fisher's exact test (p = 0.002). We conclude that posttransplantation treatment with PGE1 may have a role in preventing and suppressing the rejection process in infants receiving allograft orthotopic heart transplantation.
Assaad
A
A
Division of Neonatology, Loma Linda University Medical Center, CA 92354.
D000527:Alprostadil / Q000008:administration & dosage*; D004373:Ductus Arteriosus / Q000187:drug effects; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007231:Infant, Newborn; D008297:Male
D007166:Immunosuppressive Agents; D000527:Alprostadil