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Paediatric cardiac transplantation with steroid-sparing maintenance immunosuppression

Au, J., Gregory, John Welbourn, Colquhoun, I. W., Scott, C. D., Hilton, C. J., Hunter, S. and Dark, J. H. 1992. Paediatric cardiac transplantation with steroid-sparing maintenance immunosuppression. Archives of Disease in Childhood 67 (10) , pp. 1262-1266. 10.1136/adc.67.10.1262

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In order to determine the results of steroid-sparing maintenance immunosuppression in paediatric patients who have undergone orthotopic heart transplantation (OHT), a retrospective study was undertaken in 12 children and five infants (median age 3.5 years). Preoperative diagnoses were cardiomyopathy in seven and congenital heart disease in 10 patients. Immunosuppression was induced by cyclosporin, azathioprine, methylprednisolone, and antihuman lymphocyte immune globulin. It was maintained with cyclosporin and azathioprine. After induction, five patients received no further steroids. The remainder, except one, required only pulses for rejection (13 episodes or 0.51 episodes/patient year). Long term complications included hypertension in six, and renal impairment in three children. There were no early or late deaths from infection. Actuarial survival was 94% at one year. Of the children followed up for more than one year, all demonstrated an increase in height SD scores (mean (SD) -2.15 (1.35) to -1.15 (1.16)). We conclude that a steroid-sparing maintenance immunosuppression regimen can be successfully employed in paediatric OHT, and that significant catch-up growth can be achieved postoperatively

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RZ Other systems of medicine
Publisher: BMJ Publishing Group
ISSN: 0003-9888
Last Modified: 04 Jun 2017 07:55

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