[Cardiac retransplantation in childhood. Questions and answers].
Cardiac transplantation in childhood remains a long-term palliative procedure and it is probable that an increasing number of patients undergoing this procedure in childhood will require a new transplant one day. Coronary artery disease of the transplanted heart is the main indication. The results (in terms of survival and morbidity) in the literature and in the authors' experience are encouraging and justify the indication for retransplantation in cases of severe coronary disease of the transplanted heart. The indication is not as clear-cut in transplantation performed early or as an emergency for primary graft dysfunction, which carries a high mortality. Renal failure and allo-immunisation are not contra-indications to this procedure. Occasionally, procedures of coronary revascularisation provide time to wait for a new transplant. In the absence of more effective preventive or curative treatment of coronary disease of the transplant, the good results of retransplantation justify the procedure for this indication and reinscription on the waiting list for cardiac transplantation.
Iserin
F
F
Service de cardiologie pédiatrique, hôpital Necker-Enfants malades, Paris 75015. franck.iserin@nck.ap-hop-paris.fr
Le Bidois
J
J
Tamisier
D
D
Sidi
D
D
D000293:Adolescent; D009202:Cardiomyopathies / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003327:Coronary Disease / Q000209:etiology* / Q000601:surgery; D003404:Creatinine / Q000652:urine; D006084:Graft Rejection / Q000517:prevention & control / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000502:physiology; D012086:Reoperation / Q000401:mortality; D015996:Survival Rate; D014850:Waiting Lists
D007166:Immunosuppressive Agents; D003404:Creatinine