Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil

AUTOR(ES)

Cajueiro, Francisco Candido Monteiro; Croti, Ulisses Alexandre; Barufi, Alexandra Regina Siscar; Bodini, André Luís de Andrade; Postigo, Karolyne Barroca Sanches; Marchi, Carlos Henrique De; Santos, Fernando Cesar Gimenes Barbosa; Beani, Lilian; Borim, Bruna Cury; Godoy, Moacir Fernandes; Moscardini, Airton Camacho

FONTE

Brazilian Journal of Cardiovascular Surgery

DATA DE PUBLICAÇÃO

2022

RESUMO

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.

Documentos Relacionados

• EUS-guided gastroenterostomy: Initial experience in a brazilian tertiary center
• Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil
• Use of lacosamide in children: experience of a tertiary medical care center in Brazil
• Outcomes among pediatric heart transplant recipients.
• Operative treatment of tertiary hyperparathyroidism: a single-center experience.