Source: Annual Congress 2006 - Pneumonia and other invasive pulmonary infections in children
Disease area: Respiratory infections

Abstract

Background:
The frequency and spectrum of chronic respiratory complications in paediatric heart transplant recipients have not been extensively studied.
Aim:
To describe the chronic respiratory complications in 134 consecutive paediatric heart transplant recipients.
Materials and Methods:
Retrospective review of medical records.
Results:
134 heart transplants were performed between 1987 and 2005 in this regional centre. The mean age at transplant was 7.4 years (range 0.1-17) and the mean length of follow up was 6.8 years. 23 patients have died and 36 have been transferred to adult follow up, leaving 75 under paediatric follow up. Chronic respiratory complications have been documented in 33 (33/75 = 44%) children. Bronchiectasis has been identified in 10 children; this was most frequently related to the well described problem of polysaccharide antibody deficiency occurring in children transplanted and receiving immunosuppressive therapy in the first two years of life. Twelve further children have had recurrent lower respiratory tract infections (without bronchiectasis) requiring long term antibiotic prophylaxis. Obstructive sleep apnoea occurred in five children. Subglottic stenosis has occurred in three children. Significant compression of the left main stem bronchus related to a disproportionately large donor heart has occurred in two children. One child developed Obliterative Bronchiolitis.
Conclusion:
Chronic respiratory complications are common in paediatric heart transplant recipients. The respiratory prognosis for this complex group of patients is usually good, but long term follow up by both respiratory paediatrician and immunologist is frequently required.

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Citations should be made in the following way:
B. Thomas, D. A. Spencer, J. Flett, R. Shyam (Newcastle upon Tyne, United Kingdom). Chronic respiratory complications in paediatric heart transplant recipients. Eur Respir J 2006; 28: Suppl. 50, 1790

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