Neonatal Cardiac Transplantation: Intermediate-Term Results and Incidence of Rejection

doi:10.1001/archsurg.1992.01420090080011

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Vol. 127 No. 9, September 1992

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PAPERS PRESENTED AT THE 63RD ANNUAL MEETING OF THE PACIFIC COAST SURGICAL ASSOCIATION, KAUAI, HAWAII, FEBRUARY 16-19, 1992

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Neonatal Cardiac Transplantation

Intermediate-Term Results and Incidence of Rejection

Mario Chiavarelli, MD, PhD; Mark M. Boucek, MD; Sandra L. Nehlsen-Cannarella, PhD; Steven R. Gundry, MD; Anees J. Razzouk, MD; Leonard L. Bailey, MD; Loma Linda University Pediatric Heart Transplant Group

Arch Surg. 1992;127(9):1072-1076.

Abstract

• Early age at cardiac transplantation may favor successfulengrafting with minimal chronic immunosuppression. Fifty-twonewborns underwent orthotopic heart transplantation; 47 (90%)survived the operation, and 44 (85%) were late survivors. Actuarialsurvival was 92% at 1 month, 86% at 1 year, and 84% at 5 years.Forty-four infants who survived 12 weeks and the corresponding100 rejection episodes were analyzed. Mean follow-up was 2.2years. The mean number of rejections per year of follow-up was1.2. No episodes of rejection were identified in six patients.Seven patients had a late rejection episode more than 1 yearafter transplantation, and only one had a late rejection episodeafter 2 years. Neonatal cardiac transplantation is effectiveand durable therapy for uncorrectable heart disease. Intermediate-termresults are excellent. Severe rejection is uncommon, and fewepisodes occur after 1 year of follow-up.

(Arch Surg. 1992;127:1072-1076)

Author Affiliations

From the Division of Cardiothoracic Surgery, Department of Surgery, Loma Linda (Calif) International Heart Institute (Drs Chiavarelli, Gundry, Razzouk, and Bailey), the Division of Pediatric Cardiology, Department of Pediatrics, Loma Linda International Heart Institute (Dr Boucek), and the LLUMC Immunology Center (Dr Nehlsen-Cannarella), Loma Linda University School of Medicine, Loma Linda University Medical Center.

Footnotes

Accepted for publication June 6, 1992.

Presented at the 63rd Annual Meeting of the Pacific Coast SurgicalAssociation, Kauai, Hawaii, February 17, 1992.

Reprint requests to Loma Linda University Medical Center, 11234Anderson St, Loma Linda, CA 92354 (Dr Bailey).

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