From the Department of Pediatric Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2022 Feb;20(2):173-179. doi: 10.6002/ect.2020.0349. Epub 2021 Mar 31.
Neurologic complications that can lead to serious mortality and morbidity in pediatric heart transplant recipients have been reported to range from 23.6% to 45%. In this study, the frequency, time, cause, and characteristics of neurologic complications in pediatric heart transplant recipients were evaluated.
We retrospectively reviewed data of 37 pediatric heart transplant recipients aged <18 years who were seen at our hospital between 2007 and 2017. Medical records were reviewed to identify neurologic complications. Clinical features were compared between pediatric heart transplant patients with and without neurologic complications.
The rate of posttransplant neurologic complications in pediatric heart transplant was 27% (10/37). Median age of patients with neurologic complications was 12 years (range, 11-18 years). Median time for neurologic complications was 3 days (range, 2-46 days). Primary diagnoses of these 10 recipients were dilated cardiomyopathy (n = 7) and restrictive cardiomyopathy (n = 3). There were no significant differences between recipients with and without neurologic complications (P > .05).The etiologies of neurologic complications were posterior reversible encephalopathy syndrome in 3 patients (8.1%), stroke in 2 patients (5.4%), peripheral neuropathy in 2 patients (5.4%), hypertensive encephalopathy in 1 patient (2.7%), and drug encephalopathy in 1 patient (2.7%).
Neurologic complications may lead to serious mortality and morbidity in pediatric heart transplant patients. Seizures, posterior reversible encephalopathy syndrome, stroke, peripheral neuropathy, transient ischemic attack, and cerebral infections are the most common neurologic complications, which are seen in the perioperative period in particular. Careful follow-up of pediatric heart transplant patients, with detection and early treatment of neurologic findings, will contribute to lower rates of sequelae. To our knowledge, this is the largest study to show a detailed experience of neurologic complications in pediatric heart transplant patients from a single center in Turkey.
据报道，在儿科心脏移植受者中，可能导致严重死亡率和发病率的神经并发症发生率范围为 23.6%至 45%。在这项研究中，评估了儿科心脏移植受者神经并发症的频率、时间、原因和特征。
我们回顾性分析了 2007 年至 2017 年间在我院就诊的 37 名年龄<18 岁的儿科心脏移植受者的数据。回顾病历以确定神经并发症。比较有和无神经并发症的儿科心脏移植患者的临床特征。
儿科心脏移植后发生神经并发症的比例为 27%（10/37）。有神经并发症的患者的中位年龄为 12 岁（范围，11-18 岁）。神经并发症的中位时间为 3 天（范围，2-46 天）。这 10 名受者的主要诊断分别为扩张型心肌病（n=7）和限制型心肌病（n=3）。有和无神经并发症的受者之间无显著差异（P>.05）。神经并发症的病因包括 3 例（8.1%）后可逆性脑病综合征、2 例（5.4%）中风、2 例（5.4%）周围神经病、1 例（2.7%）高血压脑病和 1 例（2.7%）药物性脑病。
神经并发症可能导致儿科心脏移植患者严重的死亡率和发病率。癫痫发作、后可逆性脑病综合征、中风、周围神经病、短暂性脑缺血发作和脑感染是最常见的神经并发症，特别是在围手术期。仔细随访儿科心脏移植患者，及时发现和早期治疗神经表现，将有助于降低后遗症的发生率。据我们所知，这是土耳其单一中心报告的最大规模的儿科心脏移植患者神经并发症详细经验研究。
