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Moderate acute rejection detected during annual catheterization in pediatric heart transplant recipients
- Source :
-
Journal of Heart & Lung Transplantation . Mar2003, Vol. 22 Issue 3, p276. 5p. - Publication Year :
- 2003
-
Abstract
- : Background:Acute rejection commonly occurs within the first year after heart transplantation, and then decreases in frequency with time. Recently, the long-term utility of endomyocardial biopsy during routine annual catheterization has been questioned. The purpose of this study was to retrospectively review the prevalence of biopsy-proven rejection during routine annual catheterization in our patient population, determine whether biopsies late after transplant are useful, and identify factors that correlate with late unsuspected rejection.: Methods:Biopsy results from the annual catheterization were evaluated from 1986 to August 2000. The prevalence of moderate rejection was evaluated and compared with the patient’s immunosuppressive regimen; the prevalence of late rejection; and how late rejection correlated with recipient age, number of first-year rejections and presence of sub-therapeutic cyclosporine.: Results:A total of 1,108 biopsies were performed in 269 children with a mean follow-up of 5 ± 3 years (median 5 years, range 1 to 11 years). Three-drug immunosuppressive therapy, including steroids, was used in 93 patients. There was a persistent 8% to 10% prevalence of moderate rejection at up to 10 years post-transplantation. Moderate rejection was more likely in patients: (1) on 3-drug immunosuppressive therapy; (2) with a recipient age >1 year; and (3) with a relatively lower cyclosporine level.: Conclusions:These data suggest that continued surveillance of pediatric transplant patients for acute rejection is indicated for long-term follow-up. [Copyright &y& Elsevier]
- Subjects :
- *HEART transplantation
*CATHETERIZATION
*BIOPSY
*STEROIDS
*CYCLOSPORINE
Subjects
Details
- Language :
- English
- ISSN :
- 10532498
- Volume :
- 22
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Journal of Heart & Lung Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 9233089
- Full Text :
- https://doi.org/10.1016/S1053-2498(02)00551-X