Zetina TH, Calderón AM, Sánchez VLD, Galván DJ, Martínez GE, Villaseñor CC

Language: Spanish
References: 14
Page: 96-98
PDF size: 39.71 Kb.

ABSTRACT

Objective: To report a case of acute cardiac allograft rejection manifested as right cardiac failure. Design: Case report. Setting: Cardiac surgery ICU of a tertiary care hospital, Mexico City. Patient: A 17-yr-old heart-transplanted man with acute rejection. Interventions: Echocardiography, cardiac catheterization, cardiac biopsy and use of methylprednisolone. Results: Right ventricular dilatation, right ventricular ejec-tion fraction 20%, acute cardiac rejection grade III-B. After the treatment with methylprednisolone the course was satisfactory. Conclusion: An unusual manifestation of acute cardiac allograft rejection is acute right cardiac failure.

REFERENCES

1. Young J, Frost A, Short HD. A clinical perspective of heart and lung transplantation. In: Shearer W, Fleisher T. Immunology and Allergy Clinics of North America. Organ and Bone Marrow Transplantation. Editorial WB Saunders Company, Philadelphia, PA. USA. 1996; 16(2): 265-91.

2. Caves P, Stinson E, Billingham M, Rider A, Shumway N. Diagnosis of human cardiac allograft rejection by serial cardiac biopsy. J Thorac Cardiovasc Surg 1973; 66(3): 461-6.

3. Kobashigawa J, Kirklin J, Naftel D, Bourge R, Ventura H, Mohanty P et al. Pretransplantation risk factors for acute rejection after heart transplantation: A multiinstitutional study. J Heart Lung Transplant 1993; 12(3): 355-66.

4. Carlson R, Geheb M. Critical care of the transplant patient. In: Burdine J, Fischel R, Bolman III R. Cardiac Transplantation 1990; 6(4): 927-45.

5. Miller L, Schlant R, Kobashigawa J, Kubo S, Renlud D. Complications of heart transplantation. Task Force 5. JCCC 1993; 22(1): 41-52.

6. Bourge R, Naftel D, Costanzo-Nordin M, Kirklin J, Young J, Kibo S et al. Pretransplantation risk factors for death after heart transplantation: A multiinstitutional study. J Heart & Lung Transplant 1993; 12(4): 549-62.

7. Sharples L, Caine N, Mullins P, Scott J, Solis E, English T et al. Risk factor analysis for the major hazards following heart transplantation-rejection, infection, and coronary occlusive disease. Transplantation 1991; 52(2): 244-52.

8. Hosenpud J, Novick R, Bennett L, Keck B, Fiol B, Daily P. The registry of the International Society for Heart and Lung Transplantation: Thirteenth Official Report 1996. J Heart & Lung Transplant 1996; 15(7): 655-74.

9. Moriguchi J, Stevenson L, Kobashigawa J, Westlake C, Laks H, Child J. Decrease in 2-dimensional echocardiographic ejection fraction during transplant rejection: A study of 400 biopsies. Abstracts. JACC 1998; 11(2): 121 A.

10. Desruennes M, Corcos T, Cabrol A, Gandjbakhch I, Pavie A, Léger P et al. Doppler echocardiographic for the diagnosis of acute cardiac allograft rejection. JACC 1988; 12(1): 63-70.

11. Haberl R, Weber M, Reichenspurner H, Kemkes B, Osterholser G, Anthuber M et al. Frequency analysis of the surface electrocardiogram for recognition of acute rejection after orthotopic cardiac transplantation in man. Circulation 1987; 11(1): 101-8.

12. Kirklin J, Naftel D, McGiffin D, McVay R, Blackstone E, Karp R. Analysis of morbid events and risk factors for death after cardiac transplantation. J Am Coll Cardiol 1998; 11: 917-24.

13. Carrier M, Blaise G, Bélisle S, Perrault L, Pellerin M, Petitclerc R et al. Nitric oxide inhalation in the treatment of primary graft failure following heart transplantation. J Heart & Lung Transplant 1999; 18: 664-7.

14. Billingham M, Hammond E. A working foundation for the standardization of nomenclature in the diagnosis of heart and lung rejection. Heart Rejection Study Group. J Heart Transplant 1990; 9: 587.