Long-term survivors of pediatric heart transplantation: A multicenter report of sixty-eight children who have survived longer than five years

G. Sigfusson, F. J. Fricker, D. Bernstein, L. J. Addonizio, D. Baum, Daphne T. Hsu, C. Chin, S. A. Miller, G. J. Boyle, J. Miller, K. S. Lawrence, J. F. Douglas, B. P. Griffith, B. A. Reitz, Robert E. Michler, E. A. Rose, S. A. Webber

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Objective: Short-term survival after pediatric heart transplantation is now excellent, but ultimately the efficacy of this procedure will depend on duration and quality of survival. We sought to evaluate the clinical course of long-term survivors of heart transplantation in childhood. Methods: Patients who had undergone heart transplantation at the university hospitals of Stanford. Columbia, and Pittsburgh between 1975 and 1989 and survived longer than 5 years from transplantation were identified and their clinical courses retrospectively reviewed. Results: Sixty eight children have survived more than 5 years from transplantation, and 60 (88%) are currently alive with a median follow-up of 6.8 years (5 to 17.9 years). Thirteen have survived more than 10 years from transplantation. Renal dysfunction caused by immunosuppressive agents was common, and two patients required late renal transplantation. Lymphoproliferative disease or other neoplasm occurred in 12 patients, but none resulted in death. Coronary artery disease was diagnosed in 13 patients (19%), leading to retransplantation in eight. Death after 5 years was related to acute or chronic rejection in 5 of 8 cases. Two of the deaths were directly related to noncompliance with immunosuppressive medication. All survivors are in New York Heart Association Class 1. Conclusions: Long-term survival with good quality of life can be achieved after heart transplantation in childhood, though complications of immunosuppression remain common. Posttransplantation coronary artery disease is emerging as the main factor limiting long term graft and patient survival.

Original languageEnglish (US)
Pages (from-to)862-871
Number of pages10
JournalJournal of Pediatrics
Volume130
Issue number6
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Heart Transplantation
Survivors
Pediatrics
Transplantation
Immunosuppressive Agents
Survival
Coronary Artery Disease
Graft Survival
Kidney Transplantation
Immunosuppression
Quality of Life
Kidney
Neoplasms

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Long-term survivors of pediatric heart transplantation : A multicenter report of sixty-eight children who have survived longer than five years. / Sigfusson, G.; Fricker, F. J.; Bernstein, D.; Addonizio, L. J.; Baum, D.; Hsu, Daphne T.; Chin, C.; Miller, S. A.; Boyle, G. J.; Miller, J.; Lawrence, K. S.; Douglas, J. F.; Griffith, B. P.; Reitz, B. A.; Michler, Robert E.; Rose, E. A.; Webber, S. A.

In: Journal of Pediatrics, Vol. 130, No. 6, 1997, p. 862-871.

Research output: Contribution to journalArticle

Sigfusson, G, Fricker, FJ, Bernstein, D, Addonizio, LJ, Baum, D, Hsu, DT, Chin, C, Miller, SA, Boyle, GJ, Miller, J, Lawrence, KS, Douglas, JF, Griffith, BP, Reitz, BA, Michler, RE, Rose, EA & Webber, SA 1997, 'Long-term survivors of pediatric heart transplantation: A multicenter report of sixty-eight children who have survived longer than five years', Journal of Pediatrics, vol. 130, no. 6, pp. 862-871. https://doi.org/10.1016/S0022-3476(97)70270-1
Sigfusson, G. ; Fricker, F. J. ; Bernstein, D. ; Addonizio, L. J. ; Baum, D. ; Hsu, Daphne T. ; Chin, C. ; Miller, S. A. ; Boyle, G. J. ; Miller, J. ; Lawrence, K. S. ; Douglas, J. F. ; Griffith, B. P. ; Reitz, B. A. ; Michler, Robert E. ; Rose, E. A. ; Webber, S. A. / Long-term survivors of pediatric heart transplantation : A multicenter report of sixty-eight children who have survived longer than five years. In: Journal of Pediatrics. 1997 ; Vol. 130, No. 6. pp. 862-871.
@article{6c6295c1aa7e4ea89020fcb073747db5,
title = "Long-term survivors of pediatric heart transplantation: A multicenter report of sixty-eight children who have survived longer than five years",
abstract = "Objective: Short-term survival after pediatric heart transplantation is now excellent, but ultimately the efficacy of this procedure will depend on duration and quality of survival. We sought to evaluate the clinical course of long-term survivors of heart transplantation in childhood. Methods: Patients who had undergone heart transplantation at the university hospitals of Stanford. Columbia, and Pittsburgh between 1975 and 1989 and survived longer than 5 years from transplantation were identified and their clinical courses retrospectively reviewed. Results: Sixty eight children have survived more than 5 years from transplantation, and 60 (88{\%}) are currently alive with a median follow-up of 6.8 years (5 to 17.9 years). Thirteen have survived more than 10 years from transplantation. Renal dysfunction caused by immunosuppressive agents was common, and two patients required late renal transplantation. Lymphoproliferative disease or other neoplasm occurred in 12 patients, but none resulted in death. Coronary artery disease was diagnosed in 13 patients (19{\%}), leading to retransplantation in eight. Death after 5 years was related to acute or chronic rejection in 5 of 8 cases. Two of the deaths were directly related to noncompliance with immunosuppressive medication. All survivors are in New York Heart Association Class 1. Conclusions: Long-term survival with good quality of life can be achieved after heart transplantation in childhood, though complications of immunosuppression remain common. Posttransplantation coronary artery disease is emerging as the main factor limiting long term graft and patient survival.",
author = "G. Sigfusson and Fricker, {F. J.} and D. Bernstein and Addonizio, {L. J.} and D. Baum and Hsu, {Daphne T.} and C. Chin and Miller, {S. A.} and Boyle, {G. J.} and J. Miller and Lawrence, {K. S.} and Douglas, {J. F.} and Griffith, {B. P.} and Reitz, {B. A.} and Michler, {Robert E.} and Rose, {E. A.} and Webber, {S. A.}",
year = "1997",
doi = "10.1016/S0022-3476(97)70270-1",
language = "English (US)",
volume = "130",
pages = "862--871",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Long-term survivors of pediatric heart transplantation

T2 - A multicenter report of sixty-eight children who have survived longer than five years

AU - Sigfusson, G.

AU - Fricker, F. J.

AU - Bernstein, D.

AU - Addonizio, L. J.

AU - Baum, D.

AU - Hsu, Daphne T.

AU - Chin, C.

AU - Miller, S. A.

AU - Boyle, G. J.

AU - Miller, J.

AU - Lawrence, K. S.

AU - Douglas, J. F.

AU - Griffith, B. P.

AU - Reitz, B. A.

AU - Michler, Robert E.

AU - Rose, E. A.

AU - Webber, S. A.

PY - 1997

Y1 - 1997

N2 - Objective: Short-term survival after pediatric heart transplantation is now excellent, but ultimately the efficacy of this procedure will depend on duration and quality of survival. We sought to evaluate the clinical course of long-term survivors of heart transplantation in childhood. Methods: Patients who had undergone heart transplantation at the university hospitals of Stanford. Columbia, and Pittsburgh between 1975 and 1989 and survived longer than 5 years from transplantation were identified and their clinical courses retrospectively reviewed. Results: Sixty eight children have survived more than 5 years from transplantation, and 60 (88%) are currently alive with a median follow-up of 6.8 years (5 to 17.9 years). Thirteen have survived more than 10 years from transplantation. Renal dysfunction caused by immunosuppressive agents was common, and two patients required late renal transplantation. Lymphoproliferative disease or other neoplasm occurred in 12 patients, but none resulted in death. Coronary artery disease was diagnosed in 13 patients (19%), leading to retransplantation in eight. Death after 5 years was related to acute or chronic rejection in 5 of 8 cases. Two of the deaths were directly related to noncompliance with immunosuppressive medication. All survivors are in New York Heart Association Class 1. Conclusions: Long-term survival with good quality of life can be achieved after heart transplantation in childhood, though complications of immunosuppression remain common. Posttransplantation coronary artery disease is emerging as the main factor limiting long term graft and patient survival.

AB - Objective: Short-term survival after pediatric heart transplantation is now excellent, but ultimately the efficacy of this procedure will depend on duration and quality of survival. We sought to evaluate the clinical course of long-term survivors of heart transplantation in childhood. Methods: Patients who had undergone heart transplantation at the university hospitals of Stanford. Columbia, and Pittsburgh between 1975 and 1989 and survived longer than 5 years from transplantation were identified and their clinical courses retrospectively reviewed. Results: Sixty eight children have survived more than 5 years from transplantation, and 60 (88%) are currently alive with a median follow-up of 6.8 years (5 to 17.9 years). Thirteen have survived more than 10 years from transplantation. Renal dysfunction caused by immunosuppressive agents was common, and two patients required late renal transplantation. Lymphoproliferative disease or other neoplasm occurred in 12 patients, but none resulted in death. Coronary artery disease was diagnosed in 13 patients (19%), leading to retransplantation in eight. Death after 5 years was related to acute or chronic rejection in 5 of 8 cases. Two of the deaths were directly related to noncompliance with immunosuppressive medication. All survivors are in New York Heart Association Class 1. Conclusions: Long-term survival with good quality of life can be achieved after heart transplantation in childhood, though complications of immunosuppression remain common. Posttransplantation coronary artery disease is emerging as the main factor limiting long term graft and patient survival.

UR - http://www.scopus.com/inward/record.url?scp=0030694849&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030694849&partnerID=8YFLogxK

U2 - 10.1016/S0022-3476(97)70270-1

DO - 10.1016/S0022-3476(97)70270-1

M3 - Article

C2 - 9202606

AN - SCOPUS:0030694849

VL - 130

SP - 862

EP - 871

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 6

ER -