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Arch Pediatr Adolesc Med. 1994 Sep;148(9):973-9.

Neurologic complications of pediatric heart transplantation.

Author information

1
Department of Neurology, St Louis Children's Hospital, Washington University School of Medicine, Mo.

Abstract

OBJECTIVE:

To determine the type and frequency of acquired neurologic complications in survivors of pediatric heart transplantation (HT).

DESIGN:

Retrospective study.

SETTING:

Tertiary care children's hospital.

PARTICIPANTS:

Fourteen survivors of 17 consecutive patients who underwent HT during a 60-month period beginning in January 1986.

INTERVENTIONS:

None. MEASUREMENTS OR MAIN RESULTS: Three distinct subgroups of patients who had undergone HT were identified: six infants with uncorrected hypoplastic left heart syndrome (HLHS), three infants with HLHS who had undergone previous stage 1 Norwood repair, and eight older children with end-stage cardiomyopathy. Fourteen (82%) of 17 children were alive at follow-up. Only one patient (7%) had a significant acquired neurologic deficit (left temporal lobe stroke with subsequent seizures in an infant with uncorrected HLHS). The remaining subjects had normal results of post-HT neurologic examinations (n = 7), minor post-HT neurologic abnormalities (n = 3), no significant change in preexisting neurologic abnormalities (n = 1), or normal neurologic status by report (n = 2). The minor neurologic abnormalities noted post-HT were dysmetria, tremor, and absent reflexes. No episodes of choreoathetosis or cyclosporine-related seizures were seen.

CONCLUSIONS:

Pediatric HT is associated with both a high survival rate and a low incidence of severe acquired neurologic deficits despite a significant incidence of severe systemic and metabolic derangements in the pretransplantation and posttransplantation periods. In infants with HLHS, HT seems to carry a lower incidence of severe neurologic morbidity (12%) than other surgical treatments.

PMID:
8075745
[Indexed for MEDLINE]

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