Early experience with pediatric cardiac transplantation in a limited resource setting.
Dilated cardiomyopathy
endomyocardial biopsy
heart failure
heart transplant
mechanical circulatory support
pediatrics
restrictive cardiomyopathy
Journal
Annals of pediatric cardiology
ISSN: 0974-2069
Titre abrégé: Ann Pediatr Cardiol
Pays: India
ID NLM: 101495459
Informations de publication
Date de publication:
Historique:
received:
26
04
2020
revised:
23
03
2020
accepted:
21
05
2020
entrez:
1
9
2020
pubmed:
31
8
2020
medline:
31
8
2020
Statut:
ppublish
Résumé
Pediatric heart transplantation is a now a well-established and standard treatment option for end stage heart failure for various conditions in children. Due to logistic issues, it is not an option for in most pediatric cardiac centres in the third world. We sought to describe our early experience in the current era in India. This is a short term retrospective chart review of pediatric patients who underwent heart transplantation at our centre. Mean/Median with standard deviation /range was used to present data. Twenty patients underwent orthotopic heart transplant between January 2016 and June 2019. The median age at transplant was 12.4years (range 3.3 to 17.3 years). The median weight was 23.2kg (range 10-80kg). The mean donor/recipient weight ratio was 1.62± 0.84. The mean ICU stay was 12.1days. The mean follow up post transplant was 2.03± 0.97years (range 10 days-3.57years). The 1 month and the 1 year survival was 100%. Biopsies were positive for significant rejection in 7 patients (35%). At the time of last follow-up, 3 patients (15%) had expired. The major post transplant morbidities were mechanical circulatory support (n=3), hypertension with seizure complex (n=3), post transplant lympho-proliferative disorder (n=1), pseudocyst of pancreas (n=1), coronary allograft vasculopathy (n=3) and systemic hypertension (n=7). All surviving patients (n=17) were asymptomatic at last follow up. The results suggest acceptable short term outcomes in Indian pediatric patients can be achieved after heart transplantation in the current era. Significant rejection episodes and coronary allograft vasculopathy need careful follow up.
Sections du résumé
BACKGROUND
BACKGROUND
Pediatric heart transplantation is a now a well-established and standard treatment option for end stage heart failure for various conditions in children. Due to logistic issues, it is not an option for in most pediatric cardiac centres in the third world.
AIM
OBJECTIVE
We sought to describe our early experience in the current era in India.
METHODS
METHODS
This is a short term retrospective chart review of pediatric patients who underwent heart transplantation at our centre. Mean/Median with standard deviation /range was used to present data.
RESULTS
RESULTS
Twenty patients underwent orthotopic heart transplant between January 2016 and June 2019. The median age at transplant was 12.4years (range 3.3 to 17.3 years). The median weight was 23.2kg (range 10-80kg). The mean donor/recipient weight ratio was 1.62± 0.84. The mean ICU stay was 12.1days. The mean follow up post transplant was 2.03± 0.97years (range 10 days-3.57years). The 1 month and the 1 year survival was 100%. Biopsies were positive for significant rejection in 7 patients (35%). At the time of last follow-up, 3 patients (15%) had expired. The major post transplant morbidities were mechanical circulatory support (n=3), hypertension with seizure complex (n=3), post transplant lympho-proliferative disorder (n=1), pseudocyst of pancreas (n=1), coronary allograft vasculopathy (n=3) and systemic hypertension (n=7). All surviving patients (n=17) were asymptomatic at last follow up.
CONCLUSION
CONCLUSIONS
The results suggest acceptable short term outcomes in Indian pediatric patients can be achieved after heart transplantation in the current era. Significant rejection episodes and coronary allograft vasculopathy need careful follow up.
Identifiants
pubmed: 32863657
doi: 10.4103/apc.APC_105_19
pii: APC-13-220
pmc: PMC7437633
doi:
Types de publication
Journal Article
Langues
eng
Pagination
220-226Informations de copyright
Copyright: © 2020 Annals of Pediatric Cardiology.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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