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Title

Outcome of acute graft rejection associated with hemodynamic compromise in pediatric heart transplant recipients

Authors
Phelps, Christina M
Buckvold, Shannon
Gralla, Jane
Ivy, D Dunbar
Pietra, Biagio A
Miyamoto, Shelley D
Published in Pediatric Cardiology. 2011, vol. 32, no. 1, p. 1-7
Abstract We sought to analyze the outcome of hemodynamically significant acute graft rejection in pediatric heart transplant recipients from a single-center experience. Acute graft rejection remains a major cause of morbidity and mortality for patients who undergo orthotopic heart transplantation and has been associated with the severity of the rejection episode. A retrospective review of all children experiencing a hemodynamically significant rejection episode after orthotopic heart transplantation was performed. Fifty-three patients with 54 grafts had 70 rejection episodes requiring intravenous inotropic support. Forty-one percent of these patients required high-dose inotropic support, with the remaining 59% of patients requiring less inotropic support. Overall graft survival to hospital discharge was 41% for patients in the high-dose group compared to 94% in the low-dose group. Six-month graft survival in patients who required high-dose inotropes remained at 41% compared to 44% in the low-dose group. Hemodynamically significant acute graft rejection in pediatric heart transplant recipients is a devastating problem with poor short- and long-term outcomes. Survival to hospital discharge is dismal in patients who require high-dose inotropic support. In contrast, survival to discharge is quite good in patients who require only low-dose inotropic support; however, six-month graft survival in this group is low secondary to a high incidence of graft failure related to worsening or aggressive transplant coronary artery disease.
Keywords ChildFemaleGraft Rejection/mortality/physiopathologyGraft SurvivalHeart Transplantation/mortalityHemodynamicsHumansMaleRetrospective Studies
Identifiers
PMID: 20963408
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Structures
Research group L'hypertension pulmonaire (pédiatrie) (228)
Citation
(ISO format)
PHELPS, Christina M et al. Outcome of acute graft rejection associated with hemodynamic compromise in pediatric heart transplant recipients. In: Pediatric Cardiology, 2011, vol. 32, n° 1, p. 1-7. https://archive-ouverte.unige.ch/unige:25130

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Deposited on : 2013-01-08

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