The Journal of Heart and Lung Transplantation
Volume 29, Issue 5 , Pages 517-522 , May 2010

Safety and early outcomes using a corticosteroid-avoidance immunosuppression protocol in pediatric heart transplant recipients

  • Tajinder P. Singh, MD, MSc

      Affiliations

    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • Corresponding Author InformationReprint requests: Tajinder P. Singh, MD, Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115. Telephone: 617-355-0558. Fax: 617-734-9930
    • ,
  • Carey Faber, AB

      Affiliations

    • Case Western Reserve University School of Medicine, Cleveland, Ohio
    • ,
  • Elizabeth D. Blume, MD

      Affiliations

    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • ,
  • Sarah Worley, MS

      Affiliations

    • Department of Quantitative Health Sciences, Cleveland Clinic Children's Hospital, Cleveland, Ohio
    • ,
  • Christopher S. Almond, MD, MPH

      Affiliations

    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • ,
  • Leslie B. Smoot, MD

      Affiliations

    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
    • ,
  • Shay Dillis, PNP

      Affiliations

    • Department of Cardiology, Children's Hospital Boston, Boston, Massachusetts
    • ,
  • Colleen Nasman, BSN

      Affiliations

    • Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland, Ohio
    • ,
  • Gerard J. Boyle, MD

      Affiliations

    • Department of Pediatric Cardiology, Cleveland Clinic Children's Hospital, Cleveland, Ohio

References 

  1. Canter CE, Moorhead S, Saffitz JE, et al. Steroid withdrawal in the pediatric heart transplant recipient initially treated with triple immunosuppression. J Heart Lung Transplant. 1994;13:74–79
  2. Webber SA. 15 years of pediatric heart transplantation at the University of Pittsburgh: lessons learned and future prospects. Pediatr Transplant. 1997;1:8–21
  3. Boucek MM, Aurora P, Edwards LB, et al. Registry of the International Society for Heart and Lung Transplantation: tenth official pediatric heart transplantation report—2007. J Heart Lung Transplant. 2007;26:796–807
  4. Chinnock RE, Baum MF, Larsen R, et al. Rejection management and long-term surveillance of the pediatric heart transplant recipient: the Loma Linda experience. J Heart Lung Transplant. 1993;12(suppl):S255–S264
  5. Smith RR, Wray J, Khaghani A, et al. Ten year survival after paediatric heart transplantation: a single centre experience. Eur J Cardiothorac Surg. 2005;27:790–794
  6. Fortuna RS, Chinnock RE, Bailey LL. Heart transplantation among 233 infants during the first six months of life: the Loma Linda experience. Clin Transplant. 1999;263–272
  7. Leonard H, Hornung T, Parry G, et al. Pediatric cardiac transplant: results using a steroid-free maintenance regimen. Pediatr Transplant. 2003;7:59–63
  8. Fullerton DA, Campbell DN, Jones SD, et al. Heart transplantation in children and young adults: early and intermediate-term results. Ann Thorac Surg. 1995;59:804–811
  9. Leonard HC, O'Sullivan JJ, Dark JH. Long-term follow-up of pediatric cardiac transplant recipients on a steroid-free regime: the role of endomyocardial biopsy. J Heart Lung Transplant. 2000;19:469–472
  10. Stewart S, Winters GL, Fishbein MC, et al. Revision of the 1990 working formulation for the standardization of nomenclature in the diagnosis of heart rejection. J Heart Lung Transplant. 2005;24:1710–1720
  11. Gossett JG, Canter CE, Zheng J, et al. Decline in rejection in the first year after pediatric cardiac transplantation: a multi-institutional study. J Heart Lung Transplant. 2009;28(suppl):S124
  12. Kirk R, Edwards LB, Aurora P, et al. Registry of the International Society for Heart and Lung Transplantation: twelfth official pediatric heart transplantation report—2009. J Heart Lung Transplant. 2009;28:993–1006
  13. Bailey LL, Gundry SR, Razzouk AJ, et al. Bless the babies: one hundred fifteen late survivors of heart transplantation during the first year of life. J Thorac Cardiovasc Surg. 1993;105:805–814
  14. Chinnock RE. Pediatric heart transplantation at Loma Linda: 1985 to 1996. Clin Transplant. 1996;145–151
  15. Rosenthal DN, Chin C, Nishimura K, et al. Identifying cardiac transplant rejection in children: diagnostic utility of echocardiography, right heart catheterization and endomyocardial biopsy data. J Heart Lung Transplant. 2004;23:323–329
  16. Pollock-BarZiv SM, Allain-Rooney T, Manlhiot C, et al. Continuous infusion of thymoglobulin for induction therapy in pediatric heart transplant recipients; experience and outcomes with a novel strategy for administration. Pediatr Transplant. 2009;13:585–589
  17. Sarwal MM, Vidhun JR, Alexander SR, et al. Continued superior outcomes with modification and lengthened follow-up of a steroid-avoidance pilot with extended daclizumab induction in pediatric renal transplantation. Transplantation. 2003;76:1331–1339
  18. Sarwal MM, Yorgin PD, Alexander S, et al. Promising early outcomes with a novel, complete steroid avoidance immunosuppression protocol in pediatric renal transplantation. Transplantation. 2001;72:13–21
  19. Kumar MS, Heifets M, Moritz MJ, et al. Safety and efficacy of steroid withdrawal two days after kidney transplantation: analysis of results at three years. Transplantation. 2006;81:832–839
  20. Rajab A, Pelletier RP, Henry ML, et al. Excellent clinical outcomes in primary kidney transplant recipients treated with steroid-free maintenance immunosuppression. Clin Transplant. 2006;20:537–546
  21. Yamani MH, Taylor DO, Czerr J, et al. Thymoglobulin induction and steroid avoidance in cardiac transplantation: results of a prospective, randomized, controlled study. Clin Transplant. 2008;22:76–81

PII: S1053-2498(09)01505-8

doi: 10.1016/j.healun.2009.11.601

The Journal of Heart and Lung Transplantation
Volume 29, Issue 5 , Pages 517-522 , May 2010

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