Barbero-Marcial M, Azeka E, Camargo P R, Riso A, Jatene M, Soares J, Snitcowsky R, Auler Júnior J O, Camargo L, Santos S, Coelho V, Atik E, Ebaid M, Jatene A
Instituto do Coração do Hospital das Clínicas, FMUSP, São Paulo.
Arq Bras Cardiol. 1996 Sep;67(3):165-70.
Heart transplantation has offered children with complex congenital heart diseases and severe cardiomyopathies a chance for survival. The present article was written to show the three year experience of this procedure at the Instituto do Coração-HCFMUSP.
The methodology used was based on heart transplant indication criteria, inclusion criteria for donors, postoperative management, immunosuppression and prophylaxis as well as treatment of potential complications.
From November 1992 to November 1995, 11 children, aged 12 days old to six years (mean 2.5 years) underwent transplantation. Sixty percent of recipients were male; weight ranged from 3.5 to 17.8 kg (mean 10.3 kg). The mean age of donors was 4.4 years (a range of three weeks to ten years), 80% male, weight ranging from 3.8 to 20 kg (median 14.3 kg). The survival rate was 91% and the remaining 10 children are doing well. The most important complications were systemic hypertension, acute rejection and infection. The number of rejections and infections per patient were 3.5 and 4.7 episodes, respectively. The follow-up was between one month to three years (average 16 months).
In this experience, heart transplantation has given an additional opportunity for children with complex congenital heart diseases and cardiomyopathies, with a survival rate of 91% in three years.
心脏移植为患有复杂先天性心脏病和严重心肌病的儿童提供了生存机会。本文旨在展示心脏科-圣保罗大学心脏研究所（Instituto do Coração-HCFMUSP）开展该手术三年的经验。
所采用的方法基于心脏移植的适应症标准、供体的纳入标准、术后管理、免疫抑制与预防以及潜在并发症的治疗。
1992年11月至1995年11月，11名年龄在12天至6岁（平均2.5岁）的儿童接受了移植手术。60%的受者为男性；体重范围为3.5至17.8千克（平均10.3千克）。供体的平均年龄为4.4岁（范围为3周至10岁），80%为男性，体重范围为3.8至20千克（中位数14.3千克）。存活率为91%，其余10名儿童情况良好。最重要的并发症是系统性高血压、急性排斥反应和感染。每位患者的排斥反应和感染次数分别为3.5次和4.7次。随访时间为1个月至3年（平均16个月）。
在此经验中，心脏移植为患有复杂先天性心脏病和心肌病的儿童提供了额外的机会，三年存活率为91%。
