Linked Life Data

17430484

Source:http://linkedlifedata.com/resource/pubmed/id/17430484

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2007-4-13
pubmed:abstractText
The use of routine endomyocardial biopsies post-heart transplant in children remains controversial. It is generally accepted as the gold standard for detecting rejection, but details of the surveillance protocol, such as number and timing of biopsies, remain uncertain, with suggestions that recent advances in immunosuppressant therapy have obviated the need to perform surveillance biopsies. We retrospectively analysed results of endomyocardial biopsies performed in our unit since the introduction of a policy of three routine biopsies in the first six months post-transplantation. We specifically examined only routine surveillance biopsies in order to determine whether clinically unsuspected cases of rejection were identified. Between January 2002 and April 2006, 63 children completed three biopsies in the first six months post-transplant. Of 189 surveillance endomyocardial biopsies, 19 (10%) patients showed significant, grade III or above, rejection. One patient had two episodes of rejection. In only one case the child was haemodynamically unstable, four cases were mildly unwell, and 14 of 19 (74%) cases demonstrated no cardiac symptoms. Four of eight cases treated with sirolimus for some part of their post-transplant course had an episode of rejection and of 54 tacrolimus-treated patients, 13 had an episode of asymptomatic rejection detected. One of the seven infants had significant episode of rejection. Asymptomatic, clinically significant rejection is detected in about 10% of biopsies overall using a three-biopsy protocol in the first six months after paediatric heart transplantation, and occurs in 24% of tacrolimus-treated patients. More frequent surveillance appears needed in children treated with sirolimus, but less frequent surveillance may be possible in infants.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1397-3142
pubmed:author
pubmed:issnType
Print
pubmed:volume
11
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
286-90
pubmed:meshHeading
pubmed:year
2007
pubmed:articleTitle
Unsuspected rejection episodes on routine surveillance endomyocardial biopsy post-heart transplant in paediatric patients.
pubmed:affiliation
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, UK.
pubmed:publicationType
Journal Article