OBJECTIVE: The most prevalent complications after pediatric heart transplantation (PTx) are infecction, rejection, coronary disease and linphatic tumors. Cardiac and non cardiac operations prevalence after PTx are unknown. The objective of this study is to present our institution experience with these operations.
METHODS: Between 1992 e 2008, 71 children (2,87±2,2years) were transplanted, being myocardiopathies (76%)the most commom indication. Actuarial survival was 89%, 73% e 57%, respectively with 1, 5 e 10 years post PTx. Cardiac operations after PTx were retransplantation, myocardial revascularization, coronary stent implantation, ascending aorta aneurysm correction, ECMO and PM implantation and bleeding review. Non cardiac operations were colecistectomy, lung biopsies, linphonode biopsies, lung tumors excision, traqueostomy, chest drainage, diafragmatic plicature, gastrostomy and abdominal tumor excision.
RESULTS: Sixteen children (22,5%) were submitted to 31 interventions(2,0±1,1/paciente). The most prevalent cardiac operations were bleeding review in 4, retransplantation in 3; ECMO support in 3 and coronary stent implantation in 2. The non cardiac operations were amigdalectomy and lung biopsy in 3, pericardial drainage and colecistectomy in 2. The mortality was 7.1%, being retransplantation the major cause. Complications related to immunossupressive therapy(coronary disease and linphoproliferative diseases) were 26.6% of interventions.
CONCLUSION: Cardiac and non cardiac operations after PTx showed low morbidity and mortality, being the complications directly related to immunossupressive therapy the most prevalent.