Use of induction therapy in pediatric heart transplant recipients in Switzerland - Analysis of the Swiss national database.
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State: Public
Version: Final published version
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Serval ID
serval:BIB_E3678433800F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Use of induction therapy in pediatric heart transplant recipients in Switzerland - Analysis of the Swiss national database.
Journal
Transplant immunology
Working group(s)
Swiss Transplant Cohort Study
Contributor(s)
Amico P., Axel A., Aubert J.D., Banz V., Sonja B., Beldi G., Berger C., Berishvili E., Binet I., Bochud P.Y., Branca S., Bucher H., Carrel T., Catana E., Chalandon Y., De Geest S., De Rougemont O., Dickenmann M., Dreifuss J.L., Duchosal M., Fehr T., Ferrari-Lacraz S., Garzoni C., Soccal P.G., Gaudet C., Golshayan D., Goossens N., Hadaya K., Halter J., Heim D., Hess C., Hillinger S., Hirsch H., Hirt P., Hofbauer G., Huynh-Do U., Immer F., Koller M., Laager M., Laesser B., Lehmann R., Leichtle A., Lovis C., Manuel O., Marti H.P., Martin P.Y., Martinelli M., McLin V., Mellac K., Merçay A., Mettler K., Mueller N., Müller A., Müller T., Müller-Arndt U., Müllhaupt B., Nägeli M., Oldani G., Pascual M., Posfay-Barbe K., Rick J., Rosselet A., Rossi S., Rothlin S., Ruschitzka F., Schanz U., Schaub S., Schnyder A., Schuurmans M., Sengstag T., Simonetta F., Staufer K., Stampf S., Steiger J., Stirniman G., Stürzinger U., Van Delden C., Venetz J.P., Villard J., Vionnet J., Wick M., Wilhlem M., Yerly P.
ISSN
1878-5492 (Electronic)
ISSN-L
0966-3274
Publication state
Published
Issued date
10/2021
Peer-reviewed
Oui
Volume
68
Pages
101443
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Data on individualized immunosuppressive protocols for the pediatric heart recipients are missing in Europe. To contribute to this very small but specialized field, we describe the use of induction therapy (IT) in pediatric heart transplant patients in Switzerland and the retrospective outcomes.
This is a retrospective national database analysis of children <19 years of age at time of heart transplantation (HT) from 05/2008-01/2018. Use of IT or no IT, use of steroids, calculated panel reactive antibodies (cPRA) and outcomes (Mortality, post-transplant lymphoproliferative disease (PTLD), rejection rates) were studied within a mean follow-up period of 2.9 years (0.2-8.1 years).
All 32 patients (12♂, 20♀), median age at HT of 6.4 years (24 days - 18 years) received IT using either polyclonal antibodies (ATG; 72%) or interleukin-2 receptor antagonist (anti-IL-2R mAb; 28%). Length of treatment was median of 4 (1-63) days. At time of HT all patients received steroids, while at discharge 32% and one year after HT 19%. Kaplan-Meier analysis of survival revealed a one-year survival of 86%. Three out of 7 patients with elevated cPRA (43%) died. Median time to first treated rejection was 19.4 months (±60.5 SD) without significant difference if treated with anti-IL-2R mAb or ATG (p:0.5). No development of PTLD, chronic renal failure needing ongoing renal replacement therapy or diabetes mellitus were recorded.
This is the first report of the national practice use of IT within Switzerland. It reveals a high use of IT, no development of PTLD and a low use of steroids at one-year post HT.
This is a retrospective national database analysis of children <19 years of age at time of heart transplantation (HT) from 05/2008-01/2018. Use of IT or no IT, use of steroids, calculated panel reactive antibodies (cPRA) and outcomes (Mortality, post-transplant lymphoproliferative disease (PTLD), rejection rates) were studied within a mean follow-up period of 2.9 years (0.2-8.1 years).
All 32 patients (12♂, 20♀), median age at HT of 6.4 years (24 days - 18 years) received IT using either polyclonal antibodies (ATG; 72%) or interleukin-2 receptor antagonist (anti-IL-2R mAb; 28%). Length of treatment was median of 4 (1-63) days. At time of HT all patients received steroids, while at discharge 32% and one year after HT 19%. Kaplan-Meier analysis of survival revealed a one-year survival of 86%. Three out of 7 patients with elevated cPRA (43%) died. Median time to first treated rejection was 19.4 months (±60.5 SD) without significant difference if treated with anti-IL-2R mAb or ATG (p:0.5). No development of PTLD, chronic renal failure needing ongoing renal replacement therapy or diabetes mellitus were recorded.
This is the first report of the national practice use of IT within Switzerland. It reveals a high use of IT, no development of PTLD and a low use of steroids at one-year post HT.
Keywords
Induction therapy, Interleukin-2 receptor antagonis, Pediatric heart transplantation, Polyclonal antibodies
Pubmed
Web of science
Create date
24/08/2021 13:21
Last modification date
27/01/2024 7:36
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