Nonadherence is associated with late rejection in pediatric heart transplant recipients

Jeremy M. Ringewald, Samuel S. Gidding, Susan E. Crawford, Carl L. Backer, Constantine Mavroudis, Elfriede Pahl

Research output: Contribution to journalArticle

Abstract

Objectives: The objective was to study the impact of nonadherence on late rejection after pediatric heart transplantation. Study design: This was a retrospective cohort study of cardiac transplant recipients surviving >6 months (n = 50). Patients were stratified by episodes of late rejection. End points were defined by cyclosporin A (CSA) level, CSA level variability, and patient admission of nonadherence. Results: In 15 patients there were 49 episodes of late rejection, and 37 (76%) were associated with nonadherence. Of these patients, 7 of 15 died, and 3 of 15 had transplant coronary artery disease. Risk factors for the rejection were single-parent home, non-white, older age, and higher CSA level variability. In 35 nonrejectors there were 4 deaths from sepsis, posttransplant lymphoproliferative disease, renal failure, and encephalomyelitis. Conclusion: Late rejection after pediatric heart transplantation is associated with nonadherence, is common during adolescence, and is associated with poor outcome.

Original languageEnglish (US)
Pages (from-to)75-78
Number of pages4
JournalJournal of Pediatrics
Volume139
Issue number1
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

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Pediatrics
Cyclosporine
Heart Transplantation
Single Parent
Encephalomyelitis
Patient Admission
Patient Compliance
Renal Insufficiency
Coronary Artery Disease
Sepsis
Cohort Studies
Retrospective Studies
Rejection (Psychology)
Transplant Recipients
Transplants

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Nonadherence is associated with late rejection in pediatric heart transplant recipients. / Ringewald, Jeremy M.; Gidding, Samuel S.; Crawford, Susan E.; Backer, Carl L.; Mavroudis, Constantine; Pahl, Elfriede.

In: Journal of Pediatrics, Vol. 139, No. 1, 01.01.2001, p. 75-78.

Research output: Contribution to journalArticle

Ringewald, Jeremy M. ; Gidding, Samuel S. ; Crawford, Susan E. ; Backer, Carl L. ; Mavroudis, Constantine ; Pahl, Elfriede. / Nonadherence is associated with late rejection in pediatric heart transplant recipients. In: Journal of Pediatrics. 2001 ; Vol. 139, No. 1. pp. 75-78.
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