Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital
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 a...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
2014-09-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000300322&lng=en&tlng=en |
| _version_ | 1811246456682577920 |
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| author | Leonardo Augusto Miana Estela Azeka Luiz Fernando Canêo Aída Luisa Turquetto Carla Tanamati Juliano Gomes Penha Alexandre Cauduro Marcelo Biscegli Jatene |
| author_facet | Leonardo Augusto Miana Estela Azeka Luiz Fernando Canêo Aída Luisa Turquetto Carla Tanamati Juliano Gomes Penha Alexandre Cauduro Marcelo Biscegli Jatene |
| author_sort | Leonardo Augusto Miana |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T14:53:47Z |
| format | Article |
| id | doaj.art-d8f214b914d842ee8254ba05d421144a |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-04-12T14:53:47Z |
| publishDate | 2014-09-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-d8f214b914d842ee8254ba05d421144a2022-12-22T03:28:20ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412014-09-0129332232910.5935/1678-9741.20140106S0102-76382014000300322Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian HospitalLeonardo Augusto MianaEstela AzekaLuiz Fernando CanêoAída Luisa TurquettoCarla TanamatiJuliano Gomes PenhaAlexandre CauduroMarcelo Biscegli JateneIntroduction: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000300322&lng=en&tlng=enTransplante de CoraçãoCardiopatias CongênitasCardiomiopatiasDoadores de TecidosSeleção do DoadorRejeição de EnxertoIsquemia Fria |
| spellingShingle | Leonardo Augusto Miana Estela Azeka Luiz Fernando Canêo Aída Luisa Turquetto Carla Tanamati Juliano Gomes Penha Alexandre Cauduro Marcelo Biscegli Jatene Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital Brazilian Journal of Cardiovascular Surgery Transplante de Coração Cardiopatias Congênitas Cardiomiopatias Doadores de Tecidos Seleção do Doador Rejeição de Enxerto Isquemia Fria |
| title | Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital |
| title_full | Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital |
| title_fullStr | Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital |
| title_full_unstemmed | Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital |
| title_short | Pediatric and congenital heart transplant: twenty-year experience in a tertiary Brazilian Hospital |
| title_sort | pediatric and congenital heart transplant twenty year experience in a tertiary brazilian hospital |
| topic | Transplante de Coração Cardiopatias Congênitas Cardiomiopatias Doadores de Tecidos Seleção do Doador Rejeição de Enxerto Isquemia Fria |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382014000300322&lng=en&tlng=en |
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