[Neonatal cardiac transplantation. Long-term results].
The pioneering work of Bailey since 1985 has made cardiac transplantation an effective treatment of left heart hypoplasia in the neonatal period. At the Marie-Lannelongue surgical centre, 5 neonates with hypoplastic left hearts or an equivalent cardiac malformation, underwent cardiac transplantation between 1993 and 1998. There were no operative deaths. At the end of the follow-up, all children were treated with cyclosporine, without steroids. One child died of a secondary acute rejection resistant to treatment 7 years after the transplantation, 1 has a severe coronary problem 13 years after the transplantation, and three children (including the diseased child) have psychomotor development abnormalities. These results and those of the literature together with the psychological problems encountered by the children and their families, do not incite in the pursuit of the neonatal transplantation program until the introduction of new drugs for the treatment of chronic rejection which should prevent the programmed death of these children.
Houyel
L
L
Service de chirurgie des cardiopathies congénitales, hôpital Marie-Lannelongue, 133, av. de la Résistance, 92350 Le Plessis-Robinson. houyel@ccml.com
Petit
J
J
Bruniaux
J
J
Planché
C
C
D001017:Aortic Coarctation / Q000209:etiology; D001706:Biopsy; D023921:Coronary Stenosis / Q000209:etiology; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control; D006323:Heart Arrest / Q000209:etiology; D006330:Heart Defects, Congenital / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D009206:Myocardium / Q000473:pathology; D011596:Psychomotor Disorders / Q000209:etiology; D012008:Recurrence; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome
D007166:Immunosuppressive Agents