Abstract
Between May 1990 and December 1992, the first 14 pediatric heart and 1 heart-lung transplants (HTx) in Argentina were: performed. Heart TX: Median age was 6 years (1-16). Diagnosis were dilated cardio-myopathy (13) and hypertrophic cardiomyopathy (1). Pulmonary vascular resistances (PVR) higher than 5 U Wood/m2 were present in 5 patients. Long distance procurement was performed in 6 cases. Average ischemic time was 2.5 hours. Weight difference between donor and recipient ranged from 100 to 550%. Inmunosupression regime consisted in cyclosporine (CyA), azathioprin (AZA), steriods (STE) and antithimocyte globulin (ATG). Acute rejection was detected by non invasive methods and routine biopsies were not permormed. Five patients required prostaglandins postoperatively for management of PVR. There were 2 early deaths, one for graft failure and the other due to multiorgan failure. One patient have a sudden death 1 year after HTx (overall mortality: 21.4%). Rejection presented in 5 children within the firt 6 months, and in 2 beyond this time. All episodes resolved with (STE) and ATG therapy. Four patients had bacterial infections and 4 developed CMV infection wich responded to specific therapy. Hypertension presented in nine children, requiring enalapril and diuretics. Average hospital stay was 20 days. All patients returned to normal life including school and sports. The longest follow up is 34 months (mean follow up: 24 months). Heart/Lung TX: The first pediatric HLTX was successfully performed in a 9 year old girl with primary pulmonary hypertension. Pulmonary rejection presented on day 21st and resolved with (STE). No further complication was observed. Pioneering efforts in pediatric heart and heartlung transplantation in Argentina have been encouraging. Logistic and social issues, together with donor scarcity, remain as major challenges to be solved.
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Florentino, J., Ricardo, L., Silvia, D. et al. HEART AND HEART-LUNG PEDIATRIC TRANSPLANTATION IN ARGENTINA. Pediatr Res 36, 825 (1994). https://doi.org/10.1203/00006450-199412000-00036
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DOI: https://doi.org/10.1203/00006450-199412000-00036