HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Starnes, V. A. Articles by Shumway, N. E. Search for Related Content PubMed PubMed Citation Articles by Starnes, V. A. Articles by Shumway, N. E.

The Annals of Thoracic Surgery, Vol 53, 306-310, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Heart, heart-lung, and lung transplantation in the first year of life

VA Starnes, PE Oyer, D Bernstein, D Baum, P Gamberg, J Miller and NE Shumway
Department of Cardiothoracic Surgery, Stanford University Medical Center, California 94305.

Seventeen infants less than 1 year of age have undergone heart (12), heart-lung (3), and lung (2) transplantation for end-stage cardiopulmonary disease. The infants undergoing heart transplantation had a mean age of 4.5 months (range, 19 days to 12 months) with the diagnosis of cardiomyopathy in 4 and congenital heart disease in 8. Four of the 8 patients (50%) had hypoplastic left heart syndrome. Actuarial survival at 1 and 2 years was 74% and compared favorably with the survival of older children at 1 and 2 years of 82% and 69%. The linearized rejection rate was less in infants as compared with children more than 1 year of age (0.61 versus 1.48 episodes per 100 patient days). In intermediate follow-up, no graft atherosclerosis has been noted. Immunosuppression has included a three-drug protocol of cyclosporine, azathioprine, and prednisone. A steroid taper to alternate day steroids or off completely by 6 months has been the goal and has been accomplished in 6 of 12 infants. Heart-lung and lung transplantation has been performed in 5 infants. One infant in each group died: 1 infant secondary to airway complications and sepsis and another due to pulmonary sepsis. A pulmonary lobe from a larger and older donor was transplanted into a 4-week-old infant as a single-lung transplant with good outcome. The 3 surviving infants are well 24, 18, and 2 months after transplantation. Obliterative bronchiolitis has not been clinically apparent in this group. These data support the clinical efficacy of heart, heart-lung, and lung transplantation in the first year of life.

This article has been cited by other articles:

				Y. S. Tjang, U. Blanz, L. Hornik, G. Tenderich, M. Morshuis, H. Stenlund, A. Bairaktaris, and R. Korfer Heart Transplantation in Children: Clinical Outcomes in a Single Center Ann. Thorac. Surg., November 1, 2007; 84(5): 1640 - 1644. [Abstract] [Full Text] [PDF]

				C. K. Choong, S. C. Sweet, T. J. Guthrie, E. N. Mendeloff, F. J. Haddad, P. Schuler, M. D. L. Morena, and C. B. Huddleston Repair of congenital heart lesions combined with lung transplantation for the treatment of severe pulmonary hypertension: A 13-year experience J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 661 - 669. [Abstract] [Full Text] [PDF]

				M. Murtra The adventure of cardiac surgery Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 167 - 180. [Full Text] [PDF]

				R. L. Applegate, L. J. Mason, and T. L. Thompson Anesthetic Management of Pediatric Cardiac Transplantation Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 55 - 61. [Abstract] [PDF]

				D. Bernstein Heart Transplantation in Neonates: Achievements, Controversies, and Challenges for the Future NeoReviews, August 1, 2000; 1(8): e152 - 159. [Full Text]

				V. A. Starnes, M. L. Barr, R. G. Cohen, J. A. Hagen, W. J. Wells, M. V. Horn, and F. A. Schenkel LIVING-DONOR LOBAR LUNG TRANSPLANTATION EXPERIENCE: INTERMEDIATE RESULTS J. Thorac. Cardiovasc. Surg., November 1, 1996; 112(5): 1284 - 1291. [Abstract] [Full Text]

				V. Alexi-Meskishvili, R. Hetzer, Y. Weng, P. E. Lange, Z. Jin, F. Berger, and M. Loebe Anomalous origin of the left coronary artery from the pulmonary artery: Early results with direct aortic reimplantation J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 354 - 362. [Abstract] [Full Text]