caa a22 4500 445823542 CHVBK 20180317145252.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00246-010-9795-5 doi (NATIONALLICENCE)springer-10.1007/s00246-010-9795-5 Outcome of Acute Graft Rejection Associated with Hemodynamic Compromise in Pediatric Heart Transplant Recipients [Elektronische Daten] [Christina Phelps, Cecile Tissot, Shannon Buckvold, Jane Gralla, D. Dunbar Ivy, Biagio Pietra, Shelley Miyamoto] We sought to analyze the outcome of hemodynamically significant acute graft rejection in pediatric heart transplant recipients from a single-center experience. Acute graft rejection remains a major cause of morbidity and mortality for patients who undergo orthotopic heart transplantation and has been associated with the severity of the rejection episode. A retrospective review of all children experiencing a hemodynamically significant rejection episode after orthotopic heart transplantation was performed. Fifty-three patients with 54 grafts had 70 rejection episodes requiring intravenous inotropic support. Forty-one percent of these patients required high-dose inotropic support, with the remaining 59% of patients requiring less inotropic support. Overall graft survival to hospital discharge was 41% for patients in the high-dose group compared to 94% in the low-dose group. Six-month graft survival in patients who required high-dose inotropes remained at 41% compared to 44% in the low-dose group. Hemodynamically significant acute graft rejection in pediatric heart transplant recipients is a devastating problem with poor short- and long-term outcomes. Survival to hospital discharge is dismal in patients who require high-dose inotropic support. In contrast, survival to discharge is quite good in patients who require only low-dose inotropic support; however, six-month graft survival in this group is low secondary to a high incidence of graft failure related to worsening or aggressive transplant coronary artery disease. Springer Science+Business Media, LLC, 2010 Acute graft rejection nationallicence Pediatric heart transplant nationallicence Phelps Christina Children's Hospital of Denver, Aurora, CO, USA aut Tissot Cecile Children's Hospital of Denver, Aurora, CO, USA aut Buckvold Shannon Children's Hospital of Denver, Aurora, CO, USA aut Gralla Jane Children's Hospital of Denver, Aurora, CO, USA aut Dunbar Ivy D. Children's Hospital of Denver, Aurora, CO, USA aut Pietra Biagio Children's Hospital of Denver, Aurora, CO, USA aut Miyamoto Shelley Children's Hospital of Denver, Aurora, CO, USA aut Pediatric Cardiology Springer-Verlag 32/1(2011-01-01), 1-7 0172-0643 32:1<1 2011 32 246 https://doi.org/10.1007/s00246-010-9795-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-010-9795-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Phelps Christina Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 700 1- Tissot Cecile Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 700 1- Buckvold Shannon Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 700 1- Gralla Jane Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 700 1- Dunbar Ivy D. Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 700 1- Pietra Biagio Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 700 1- Miyamoto Shelley Children's Hospital of Denver, Aurora, CO, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/1(2011-01-01), 1-7 0172-0643 32:1<1 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer