Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil
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| Natura: | Artículo científico |
| Lingua: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2022
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| _version_ | 1876465562840727552 |
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| author | Francisco Candido Monteiro Cajueiro |
| author_facet | Francisco Candido Monteiro Cajueiro |
| contents | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil 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 Medicina Pediatric Cardiology Heart Failure Treatment Outcome Heart Transplantation 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 BrazilMethods: 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. 2022 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398971282002 https://www.redalyc.org/journal/3989/398971282002/ https://www.redalyc.org/journal/3989/398971282002/html/ https://www.redalyc.org/journal/3989/398971282002/398971282002.epub https://www.redalyc.org/journal/3989/398971282002/movil 10.21470/1678-9741-2021-0483 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.37 |
| format | Artículo científico |
| id | redalyc_398971282002 |
| institution | Redalyc |
| language | en |
| publishDate | 2022 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil Francisco Candido Monteiro Cajueiro Medicina Pediatric Cardiology Heart Failure Treatment Outcome Heart Transplantation Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil 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 Medicina Pediatric Cardiology Heart Failure Treatment Outcome Heart Transplantation 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 BrazilMethods: 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. 2022 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398971282002 https://www.redalyc.org/journal/3989/398971282002/ https://www.redalyc.org/journal/3989/398971282002/html/ https://www.redalyc.org/journal/3989/398971282002/398971282002.epub https://www.redalyc.org/journal/3989/398971282002/movil 10.21470/1678-9741-2021-0483 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.3 Vol.37 |
| title | Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil |
| topic | Medicina Pediatric Cardiology Heart Failure Treatment Outcome Heart Transplantation |
| url | https://www.redalyc.org/articulo.oa?id=398971282002 https://www.redalyc.org/journal/3989/398971282002/ https://www.redalyc.org/journal/3989/398971282002/html/ https://www.redalyc.org/journal/3989/398971282002/398971282002.epub https://www.redalyc.org/journal/3989/398971282002/movil |