HEART AND HEART-LUNG PEDIATRIC TRANSPLANTATION IN ARGENTINA - Florentino J. Vargas et al.

12/18/2019
HEART AND HEART-LUNG PEDIATRIC TRANSPLANTATION IN ARGENTINA | Pediatric Research
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Abstract
Published: 01 December 1994
HEART AND HEART-LUNG PEDIATRIC
TRANSPLANTATION IN ARGENTINA
J Vargas Florentino, Lopez Ricardo, Diaz Silvia, Schnitzler Eduardo, Ranzini M Elena, Mengo Gustavo,
Skerl Carlos, Anglada Ana & J Marcó Del Pont
Pediatric Research 36, 825(1994)
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Abstract
Between May 1990 and December 1992, the first 14 pediatric heart and 1 heart-lung
transplants (HTx) in Argentina were: performed. Heart TX: Median age was 6 years (116). Diagnosis were dilated cardio-myopathy (13) and hypertrophic cardiomyopathy (1).
Pulmonary vascular resistances (PVR) higher than 5 U Wood/m2 were present in 5
patients. Long distance procurement was performed in 6 cases. Average ischemic time
was 2.5 hours. Weight difference between donor and recipient ranged from 100 to
550%. Inmunosupression regime consisted in cyclosporine (CyA), azathioprin (AZA),
steriods (STE) and antithimocyte globulin (ATG). Acute rejection was detected by non
invasive methods and routine biopsies were not permormed. Five patients required
prostaglandins postoperatively for management of PVR. There were 2 early deaths, one
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for graft failure and the other due to multiorgan failure. One patient have a sudden
death 1 year after HTx (overall mortality: 21.4%). Rejection presented in 5 children
within the firt 6 months, and in 2 beyond this time. All episodes resolved with (STE)
and ATG therapy. Four patients had bacterial infections and 4 developed CMV infection
wich responded to specific therapy. Hypertension presented in nine children,
requiring enalapril and diuretics. Average hospital stay was 20 days. All patients
returned to normal life including school and sports. The longest follow up is 34 months
(mean follow up: 24 months). Heart/Lung TX: The first pediatric HLTX was successfully
performed in a 9 year old girl with primary pulmonary hypertension. Pulmonary
rejection presented on day 21st and resolved with (STE). No further complication was
observed. Pioneering efforts in pediatric heart and heartlung transplantation in
Argentina have been encouraging. Logistic and social issues, together with donor
scarcity, remain as major challenges to be solved.
Author information
Affiliations
Pediatric Cardiovascular Surgery and Transplant Group, Italian Hospital, Buenos Aire,
Argentina
J Vargas Florentino, Lopez Ricardo, Diaz Silvia, Schnitzler Eduardo, Ranzini M Elena, Mengo
Gustavo, Skerl Carlos, Anglada Ana & J Marcó Del Pont
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Cite this article
Florentino, J., Ricardo, L., Silvia, D. et al. HEART AND HEART-LUNG PEDIATRIC
TRANSPLANTATION IN ARGENTINA. Pediatr Res 36, 825 (1994) doi:10.1203/00006450199412000-00036
Issue Date
DOI
01 December 1994https://doi.org/10.1203/00006450-199412000-00036
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