Introduction: Pediatric heart transplantation is the definitive therapy for children with end-stage heart failure. This paper describes our initial experience in pediatric heart transplantation in a tertiary center in Brazil.
Methods: This is a historical prospective descriptive cohort study based on a review of the medical records of children undergoing heart transplantation at Hospital de Base and Hospital da Criança e Maternidade de São José do Rio Preto. Variables were displayed as frequency, mean, or median. Statistical analysis and Kaplan-Meier actuarial curve were obtained with the aid of Microsoft® Excel® 2019 and STATSDirect version 3.3.5.
Results: Between January 2010 and December 2020, ten children underwent bicaval orthotopic heart transplantation, 30% of which were under one year of age. Nine patients had end-stage heart failure (International Society for Heart and Lung Transplantation-Heart Failure D) and 50% of the recipients were transplanted under conditions of progressive clinical deterioration (Interagency Registry for Mechanically Assisted Circulatory Support ≤ 2). Forty percent of the recipients had a panel-reactive antibody > 20% on virtual crossmatch. In the postoperative period, 80% of patients required high dose of inotropic support (vasoactive-inotropic score > 10) for > 48 hours. The death-free survival rate at 131 months was 77.1±14.4%. Most patients (88.9%) in late follow-up had an episode of active cytomegalovirus infection. Cellular rejection, with or without clinical repercussion, was present in 44.4% of the patients.
Conclusion: Pediatric heart transplantation produces acceptable and feasible outcomes as definitive therapy for children with end-stage heart failure.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9162413 | PMC |
| http://dx.doi.org/10.21470/1678-9741-2021-0483 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Use of Brain Death Recipients in Xenotransplantation: A Double-Edged Sword.
Xenotransplantation
January 2025
Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Organ transplants are used to treat many end-stage diseases, but a shortage of donors means many patients cannot be treated. Xenogeneic organs have become an important part of filling the donor gap. Many current studies of kidney, heart, and liver xenotransplantation have used gene-edited pig organs on brain-dead recipients.
View Article and Find Full Text PDFNovel Approach to Vascular Thymic Tissue Transplantation in Humans: A Case Report.
Transplant Proc
January 2025
Departamento de Imágenes Diagnósticas, Fundación Valle del Lili, Cali, Colombia.
Background: Vascular thymus transplantation has been explored in animal models but remains untested in humans. Current approaches to congenital athymia involve avascular transplantation of allogeneic thymic tissue, which may delay immune recovery. Building on animal studies, we propose revascularization of thymic tissue in a human model.
View Article and Find Full Text PDFBiomarkers of RV Dysfunction in HFrEF Identified by Direct Tissue Proteomics: Extracellular Proteins Fibromodulin and Fibulin-5.
Circ Heart Fail
January 2025
First Faculty of Medicine, Biotechnology and Biomedicine Center of the Academy of Sciences and Charles University (BIOCEV), Charles University, Prague, Czech Republic. (M.B., D.L., O.V., J.P.).
Background: Right ventricular dysfunction (RVD) is common in patients with heart failure with reduced ejection fraction, and it is associated with poor prognosis. However, no biomarker reflecting RVD is available for routine clinical use.
Methods: Proteomic analysis of myocardium from the left ventricle and right ventricle (RV) of patients with heart failure with reduced ejection fraction with (n=10) and without RVD (n=10) who underwent heart transplantation was performed.
Negative Pressure Ventilation Ex-Situ Lung Perfusion Preserves Porcine and Human Lungs for 36-Hours.
Clin Transplant
January 2025
Division of Cardiac Surgery, Department of Surgery, Faculty of Medicine, University of Alberta, Edmonton, Canada.
Introduction: Preclinically, 24-hour continuous Ex-Situ Lung Perfusion (ESLP) is the longest duration achieved in large animal models and rejected human lungs. Here, we present our 36-hour Negative Pressure Ventilation (NPV)-ESLP protocol applied to porcine and rejected human lungs.
Methods: Five sets of donor domestic pig lungs (45-55 kg) underwent 36-hour NPV-ESLP.
Venoarterial extracorporeal membrane oxygenation using magnetic levitation centrifugal pumps for fulminant myocarditis in infants, children and young adults.
Transl Pediatr
December 2024
Division of Cardiac Surgery, Department of Surgery, Dentistry, Pediatrics and Gynecology, Verona, Italy.
Background: Fulminant myocarditis (FM) is a potentially lethal disease with a wide spectrum of clinical presentation, thus making the diagnosis hard to depict. In cases where acute circulatory failure occurs venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support is a valid management strategy, especially in the pediatric and adult patients. This study aims to report the results of VA ECMO for FM in our Institution.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!