Infectious, Malignant, and Autoimmune Complications in Pediatric Heart Transplant Recipients

Agnieszka Kulikowska, Sarah E. Boslaugh, Charles B. Huddleston, Sanjiv K. Gandhi, Carl Herbert Gumbiner, Charles E. Canter

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To review clinical courses of pediatric heart transplant survivors after 5 years from transplantation for infections, lymphoproliferative, and autoimmune diseases. Study design: A total of 71 patients were examined in 2 groups, infant recipients (underwent transplant <1 year of age, n = 38) and older recipients (underwent transplant >1 year, n = 33). All patients received comparable immunosuppression. Calculated occurrence rates were reported as means per 10 years of follow-up with SEs. Differences were examined by using Poisson regression. Results: Infant recipients had significantly higher (P < .001) occurrence rates of severe (mean, 2.04 ± 0.5) and chronic infections (mean, 4.58 ± 0.67) compared with older recipients (means, 0.37 ± 0.19 and 1.87 ± 0.70, respectively). Types of infections were similar to those in the general population with extremely rare opportunistic infections; however, they were more severe and resistant to treatment. Autoimmune disorders occurred at a frequency comparable with lymphoproliferative diseases and were observed in 7 of 38 infants (18%). Most common were autoimmune cytopenias. Conclusions: Infant heart transplant recipients who survive in the long term have higher occurrence rates of infections compared with older recipients. Autoimmune disorders are a previously unrecognized morbidity in pediatric heart transplantation.

Original languageEnglish (US)
Pages (from-to)671-677
Number of pages7
JournalJournal of Pediatrics
Volume152
Issue number5
DOIs
StatePublished - May 1 2008

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Pediatrics
Infection
Opportunistic Infections
Heart Transplantation
Immunosuppression
Autoimmune Diseases
Survivors
Transplantation
Morbidity
Transplants
Transplant Recipients
Population
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Infectious, Malignant, and Autoimmune Complications in Pediatric Heart Transplant Recipients. / Kulikowska, Agnieszka; Boslaugh, Sarah E.; Huddleston, Charles B.; Gandhi, Sanjiv K.; Gumbiner, Carl Herbert; Canter, Charles E.

In: Journal of Pediatrics, Vol. 152, No. 5, 01.05.2008, p. 671-677.

Research output: Contribution to journalArticle

Kulikowska, Agnieszka ; Boslaugh, Sarah E. ; Huddleston, Charles B. ; Gandhi, Sanjiv K. ; Gumbiner, Carl Herbert ; Canter, Charles E. / Infectious, Malignant, and Autoimmune Complications in Pediatric Heart Transplant Recipients. In: Journal of Pediatrics. 2008 ; Vol. 152, No. 5. pp. 671-677.
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