Pahl E, Fricker F J, Trento A, Griffith B, Hardesty R, Gold L, Lawrence K, Beerman L, Fischer D, Neches W
Children's Hospital, Department of Pediatrics and Surgery, University of Pittsburgh, PA 15213.
Transplant Proc. 1988 Feb;20(1 Suppl 1):743-6.
The majority of late recipients of heart transplantation have returned to age-appropriate activities and are showing normal linear growth. The only child who has significant symptoms is an 11-year-old heart-lung transplant recipient who developed airway rejection with restrictive pulmonary function 14 months after transplantation. Rejection continues to be a major threat to these children more than a year removed from their transplantation procedure. Until a satisfactory noninvasive method is developed to monitor graft rejection, endomyocardial biopsies will continue to be performed at 6-month intervals. Cyclosporine nephrotoxicity and systemic hypertension remain important and unresolved problems that could limit the initial success of transplantation. We believe that heart transplantation is an acceptable option for children with end-stage heart and heart-lung disease who have a grim outlook. Future improvements in immune suppression, and the development of improved methods of assessing rejection, will allow for improved survival.
大多数晚期心脏移植受者已恢复适合其年龄的活动，并呈现出正常的线性生长。唯一有明显症状的儿童是一名11岁的心肺移植受者，他在移植后14个月出现气道排斥反应并伴有限制性肺功能。排斥反应仍然是这些儿童在移植手术一年多后面临的主要威胁。在开发出令人满意的无创方法来监测移植物排斥反应之前，仍将继续每隔6个月进行一次心内膜活检。环孢素肾毒性和全身性高血压仍然是重要且尚未解决的问题，可能会限制移植的初步成功。我们认为，心脏移植对于患有终末期心脏病和心肺疾病且前景严峻的儿童来说是一个可接受的选择。未来免疫抑制方面的改进以及评估排斥反应的改进方法的开发，将有助于提高生存率。
