Eosinophilic esophagitis in children following cardiac transplantation: association with post-transplant lymphoproliferative disorder and other transplant outcomes. Pediatr Transplant 2014 Aug;18(5):491-6
Date
06/17/2014Pubmed ID
24931365DOI
10.1111/petr.12302Scopus ID
2-s2.0-84904066427 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
Although cardiac transplantation is life-saving, morbidities from immunosuppression are significant. EoE is a complication of calcineurin inhibitors following liver transplant causing feeding intolerance, weight loss, vomiting, and dysphagia. There are limited reports of EoE following heart transplantation. We performed a retrospective single-center review of pediatric cardiac transplant patients from 2000 to 2010. A case-control analysis of patients with and without EoE was performed evaluating heart transplantation outcomes such as rates of rejection, CAV, PTLD, and graft loss. Eighty-six transplants were performed in 84 patients; 34 (40%) underwent diagnostic endoscopy, and 10 (12%) had EoE. Median time to diagnosis of EoE was 3.7 yr (IQR: 2.0-5.2). There were no differences in demographics or use of induction medications between patients with or without EoE. Patients with EoE had fewer episodes of treated rejection (1.0 vs. 2.5; p = 0.04). Four of 10 (40%) EoE patients had PTLD compared with only 2/24 (8%) of those without EoE (p = 0.048; OR 7.33 [95% CI: 1.1-50.2]). There were no differences in CAV or graft loss between groups. EoE should be considered as a cause of GI symptoms in children after cardiac transplantation and may be associated with fewer rejection episodes and increased rates of PTLD, thus representing a marker of over-immunosuppression.
Author List
Kindel SJ, Joy BF, Pahl E, Wald ELAuthor
Steven J. Kindel MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
BiopsyCalcineurin Inhibitors
Case-Control Studies
Child
Child, Preschool
Eosinophilic Esophagitis
Female
Graft Rejection
Heart Transplantation
Humans
Immunosuppressive Agents
Infant
Liver Transplantation
Lymphoproliferative Disorders
Male
Postoperative Complications
Retrospective Studies
Treatment Outcome
