Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital

Revista Brasileira de Cirurgia Cardiovascular

Leonardo Augusto Miana¹  Estela Azeka¹  Luiz Fernando Canêo¹  Aída Luisa Turquetto¹  Carla Tanamati¹  Juliano Gomes Penha¹  Alexandre Cauduro¹  Marcelo Biscegli Jatene¹ 

关键词: Heart Transplantation;    Heart Defects;    Congenital;    Cardiomyopathies;    Tissue Donors;    Donor Selection;    Graft Rejection;    Cold Ischemia;    Transplante de Coração;    Cardiopatias Congênitas;    Cardiomiopatias;    Doadores de Tecidos;    Seleção do Doador;    Rejeição de Enxerto;    Isquemia Fria;   

DOI  :  10.5935/1678-9741.20140106

来源: SciELO

【 摘 要 】

Introduction: Cardiac transplantation remains the gold standard for end-stage cardiomyopathies and congenital heart defects in pediatric patients. Objective: This study aims to report on 20 years of experience since the first case and evaluate our results. Methods: We conducted a retrospective analysis of the database and outpatient follow-up. Between October 1992 and April 2012, 109 patients underwent 114 transplants. 51.8% of them being female. The age of patients ranged from 12 days to 21 years with a mean of 8.8±5.7 years and a median of 5.2 years. The underlying diagnosis was dilated cardiomyopathy in 61.5%, congenital heart disease in 26.6% and restrictive cardiomyopathy in 11.9%. All patients above 17 years old had congenital heart disease. Results: Survival rate at 30 days, 1, 5, 10, 15, and 20 years were 90.4%, 81.3%, 70.9%, 60.5%, 44.4% and 26.7%, respectively. Mean cold ischemic time was 187.9 minutes and it did not correlate with mortality (P>0.05). Infectious complications and rejection episodes were the most common complications (P<0.0001), occurring, respectively, in 66% and 57.4% of the survivors after 10 years. There was no incidence of graft vascular disease and lymphoproliferative disease at year one, but they affected, respectively, 7.4% and 11% of patients within 10 years. Conclusion: Twenty-year pediatric heart transplant results at our institution were quite satisfactory and complication rates were acceptable.

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