Linked Life Data

19686291

Source:http://linkedlifedata.com/resource/pubmed/id/19686291

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2009-12-7
pubmed:abstractText
Despite improved immunosuppression, rejection accounts for significant morbidity and mortality in children after heart transplantation. We report the incidence and outcome of rejection of 105 children (male = 50; mean age of 8.3 +/- 5.8 years) following heart transplantation between January 2002 and August 2007. A multi-variant model was constructed for risk factors associated with significant rejection. In 271.9 patient-years of follow-up, there were 23 episodes of significant rejection (>or=3A) in 21 patients (20%). Five presented in haemodynamic collapse requiring extracorporeal membrane oxygenation support 1.6-35.9 months after transplantation; four of five survived the rejection episode. Overall rejection episodes were more common in older children, boys and those treated with sirolimus. Whereas the risk for rejection in patients on an immunosuppression regime containing tacrolimus was significantly lower. The latter finding persisted on multivariate analysis (P < 0.002). Interestingly, none of the patients who presented with haemodynamic collapse was on mycophenolate mofetil. While our experience is of a far lower incidence of rejection than registry data, rejection remains a serious problem after paediatric heart transplantation. Sirolimus without a calcineurin inhibitor was associated with more rejection episodes, whereas tacrolimus and mycophenolate appeared to provide the best protective profile.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
1432-2277
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
23
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
38-46
pubmed:meshHeading
pubmed:year
2010
pubmed:articleTitle
Acute rejection after paediatric heart transplantation: far less common and less severe.
pubmed:affiliation
Department of Paediatric Cardiology, Great Ormond Street Hospital for Children, London, UK.
pubmed:publicationType
Journal Article