Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil
ABSTRACT 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 stu...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Cirurgia Cardiovascular
2022-06-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000300281&tlng=en |
| _version_ | 1818531455380226048 |
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| author | Francisco Candido Monteiro Cajueiro Ulisses Alexandre Croti Alexandra Regina Siscar Barufi André Luís de Andrade Bodini Karolyne Barroca Sanches Postigo Carlos Henrique De Marchi Fernando Cesar Gimenes Barbosa Santos Lilian Beani Bruna Cury Borim Moacir Fernandes Godoy Airton Camacho Moscardini |
| author_facet | Francisco Candido Monteiro Cajueiro Ulisses Alexandre Croti Alexandra Regina Siscar Barufi André Luís de Andrade Bodini Karolyne Barroca Sanches Postigo Carlos Henrique De Marchi Fernando Cesar Gimenes Barbosa Santos Lilian Beani Bruna Cury Borim Moacir Fernandes Godoy Airton Camacho Moscardini |
| author_sort | Francisco Candido Monteiro Cajueiro |
| collection | DOAJ |
| description | ABSTRACT 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. |
| first_indexed | 2024-12-11T17:32:42Z |
| format | Article |
| id | doaj.art-cbe9882192e1477682a9e68cde47d732 |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-12-11T17:32:42Z |
| publishDate | 2022-06-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-cbe9882192e1477682a9e68cde47d7322022-12-22T00:56:46ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412022-06-0137328129110.21470/1678-9741-2021-0483Pediatric Heart Transplant: Initial Experience in a Tertiary Center in BrazilFrancisco Candido Monteiro CajueiroUlisses Alexandre Crotihttps://orcid.org/0000-0002-1127-4782Alexandra Regina Siscar BarufiAndré Luís de Andrade BodiniKarolyne Barroca Sanches PostigoCarlos Henrique De MarchiFernando Cesar Gimenes Barbosa SantosLilian BeaniBruna Cury BorimMoacir Fernandes GodoyAirton Camacho MoscardiniABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000300281&tlng=enHeart TransplantationPediatricHeart FailureCardiologyTreatment Outcome |
| spellingShingle | Francisco Candido Monteiro Cajueiro Ulisses Alexandre Croti Alexandra Regina Siscar Barufi André Luís de Andrade Bodini Karolyne Barroca Sanches Postigo Carlos Henrique De Marchi Fernando Cesar Gimenes Barbosa Santos Lilian Beani Bruna Cury Borim Moacir Fernandes Godoy Airton Camacho Moscardini Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil Brazilian Journal of Cardiovascular Surgery Heart Transplantation Pediatric Heart Failure Cardiology Treatment Outcome |
| title | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil |
| title_full | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil |
| title_fullStr | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil |
| title_full_unstemmed | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil |
| title_short | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil |
| title_sort | pediatric heart transplant initial experience in a tertiary center in brazil |
| topic | Heart Transplantation Pediatric Heart Failure Cardiology Treatment Outcome |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000300281&tlng=en |
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