Early primary graft failure after a pediatric heart transplant and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab

Research output: Contribution to journalArticle

Abstract

Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant. Cardiac arrest before ECMO initiation in these patients is associated with adverse neurologic outcome although those surviving to hospital discharge generally have excellent long-term outcome. We report a case of early primary graft failure after OHT who required ECMO support and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab.

Original languageEnglish (US)
Pages (from-to)69-71
Number of pages3
JournalAnnals of Pediatric Cardiology
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Plasmapheresis
Immunoglobulins
Extracorporeal Membrane Oxygenation
Pediatrics
Transplants
Heart Transplantation
Heart-Assist Devices
Graft Rejection
Heart Arrest
Nervous System
Ischemia
Hemodynamics
alemtuzumab
Mortality

Keywords

  • Alemtuzumab
  • extracorporeal membrane oxygenation
  • graft rejection
  • heart transplantation
  • plasmapheresis
  • ventricular assist device

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

@article{bc87560193cc42cca9d8e6a13a08222f,
title = "Early primary graft failure after a pediatric heart transplant and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab",
abstract = "Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant. Cardiac arrest before ECMO initiation in these patients is associated with adverse neurologic outcome although those surviving to hospital discharge generally have excellent long-term outcome. We report a case of early primary graft failure after OHT who required ECMO support and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab.",
keywords = "Alemtuzumab, extracorporeal membrane oxygenation, graft rejection, heart transplantation, plasmapheresis, ventricular assist device",
author = "Shashi Raj and Phillip Ruiz and Paolo Rusconi",
year = "2017",
month = "1",
day = "1",
doi = "10.4103/0974-2069.197063",
language = "English (US)",
volume = "10",
pages = "69--71",
journal = "Annals of Pediatric Cardiology",
issn = "0974-2069",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

TY - JOUR

T1 - Early primary graft failure after a pediatric heart transplant and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab

AU - Raj, Shashi

AU - Ruiz, Phillip

AU - Rusconi, Paolo

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant. Cardiac arrest before ECMO initiation in these patients is associated with adverse neurologic outcome although those surviving to hospital discharge generally have excellent long-term outcome. We report a case of early primary graft failure after OHT who required ECMO support and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab.

AB - Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant. Cardiac arrest before ECMO initiation in these patients is associated with adverse neurologic outcome although those surviving to hospital discharge generally have excellent long-term outcome. We report a case of early primary graft failure after OHT who required ECMO support and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab.

KW - Alemtuzumab

KW - extracorporeal membrane oxygenation

KW - graft rejection

KW - heart transplantation

KW - plasmapheresis

KW - ventricular assist device

UR - http://www.scopus.com/inward/record.url?scp=85008870562&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008870562&partnerID=8YFLogxK

U2 - 10.4103/0974-2069.197063

DO - 10.4103/0974-2069.197063

M3 - Article

AN - SCOPUS:85008870562

VL - 10

SP - 69

EP - 71

JO - Annals of Pediatric Cardiology

JF - Annals of Pediatric Cardiology

SN - 0974-2069

IS - 1

ER -