NEUROLOGICAL COMPLICATIONS AFTER PEDIATRIC HEART TRANSPLANTATION

Abstract

OBJECTIVES: Neurological complications can occur after pediatric heart transplantation and its outcome may cause disabilities and limit the prognosis of children who have undergone this procedure. The aim of the study is to evaluate the neurological complications during the first 30 days after the heart transplantation. MATERIAL AND METHODS: A survey was made at based on the InCor records to find the data. RESULTS: From September 2011 to September 2012, 15 heart transplants were performed at the Heart Institute (InCor) University of Sao Paulo Medical School. The mean age was 11.1± yr5.34 yrs, median 9.63 yrs. There were 8 (53.3%) males. The diagnosis for heart transplantation was 80% cardiomiopathies. Two of them wereë. re-transplantation. One patient was with ECMO before transplantation and one was with assist device. Seven of them were priority when listed for the heart transplantation. The immunosuppression therapy was calcineurin inhibitor and cytostatic drug. Induction therapy was performed with antithymocyte globulin. Eight (53%) of 15 patients developed neurological complications. The main cause were strokes in 37.5%. The other causes were anisocoria in 1 (12%) patient, ischemic vascular accident 1 (12%) patient, hemorrhagic vascular accident 1 (12%). Three (20%) of them died due to multiple organ failure and infection, two of them were in priority before transplant (one with assist device) and were intubated with renal failure and sedated. These two patients were the ones that showed the worse neurological complications after the transplant. CONCLUSION: Neurological complications were common after heart transplantation, patient can have favorable clinical outcome after treatment.