| Leukocyte suppression is associated with improved clinical outcomes in children's status after orthotopic heart transplantation. | |
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MedLine Citation:
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PMID: 16446220 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Leukocyte suppression is a sequela of immunosuppressive therapy after orthotopic heart transplantation and may result in discontinuation of anti-proliferative agents. Clinical outcomes in this patient population have not been well delineated. METHODS: This study was a retrospective review of children who underwent orthotopic heart transplantation at our institution from 1986 to 2003. Leukocyte suppression was defined as a white blood cell count <5,000, prompting the withdrawal of anti-proliferative agents. The population was divided into 2 groups, leukosuppressed (LS) and non-leukosuppressed (NLS), and their clinical outcomes were compared. RESULTS: The study included 109 patients, of which 44 (40%) became leukosuppressed. The 2 groups were similar regarding demographic data and initial management. The LS Group had a significantly decreased incidence of rejection, being 7 times less likely to have recurrent rejection (p = 0.001). The median time to rejection was 0.8 +/- 0.6 years for the NLS Group, whereas the median time to rejection was not yet reached at 17 years for the LS Group. The LS Group also tended toward a decreased incidence of retransplantation or death (p = 0.06). The organ "half-life" in the NLS Group was 7.5 years vs 12.5 years in the LS Group. There was no difference between the 2 groups in regards to other adverse effects of immunosuppression. CONCLUSIONS: Children who have undergone orthotopic heart transplantation and subsequently become leukosuppressed have a lower incidence of rejection and a tendency toward less organ loss than children who do not become leukosuppressed, without having an increased incidence of adverse side effects. |
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Authors:
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Jeffrey J Kim; William J Dreyer; E O'Brian Smith; Jack F Price; Sarah Clunie; V Vasiliki Dimas; John L Jefferies; Howard Rosenblatt; Branislav Radovancevic; Jeffrey A Towbin; Susan W Denfield |
Publication Detail:
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Type: Journal Article Date: 2005-12-15 |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 25 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-01-31 Completed Date: 2006-08-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
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Languages: eng Pagination: 195-9 Citation Subset: IM |
Affiliation:
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Section of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA. jjkim@texaschildrenshospital.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cell Proliferation / drug effects Child Child, Preschool Female Graft Rejection / etiology, physiopathology, prevention & control Heart Transplantation / immunology*, methods, pathology Humans Immunosuppression / adverse effects Immunosuppressive Agents / adverse effects, pharmacology*, therapeutic use Infant Leukocytes / drug effects*, pathology*, physiology Leukopenia* / chemically induced Male Multivariate Analysis Postoperative Complications / immunology, pathology Retrospective Studies Risk Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Immunosuppressive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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