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Nonadherence is associated with late rejection in pediatric heart transplant recipients.

Publication ,  Journal Article
Ringewald, JM; Gidding, SS; Crawford, SE; Backer, CL; Mavroudis, C; Pahl, E
Published in: J Pediatr
July 2001

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, post-transplant 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.

Duke Scholars

Published In

J Pediatr

DOI

ISSN

0022-3476

Publication Date

July 2001

Volume

139

Issue

1

Start / End Page

75 / 78

Location

United States

Related Subject Headings

  • Treatment Refusal
  • Time Factors
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Outcome Assessment, Health Care
  • Male
  • Immunosuppressive Agents
  • Humans
  • Heart Transplantation
 

Citation

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Ringewald, J. M., Gidding, S. S., Crawford, S. E., Backer, C. L., Mavroudis, C., & Pahl, E. (2001). Nonadherence is associated with late rejection in pediatric heart transplant recipients. J Pediatr, 139(1), 75–78. https://doi.org/10.1067/mpd.2001.115067
Ringewald, J. M., S. S. Gidding, S. E. Crawford, C. L. Backer, C. Mavroudis, and E. Pahl. “Nonadherence is associated with late rejection in pediatric heart transplant recipients.J Pediatr 139, no. 1 (July 2001): 75–78. https://doi.org/10.1067/mpd.2001.115067.
Ringewald JM, Gidding SS, Crawford SE, Backer CL, Mavroudis C, Pahl E. Nonadherence is associated with late rejection in pediatric heart transplant recipients. J Pediatr. 2001 Jul;139(1):75–8.
Ringewald, J. M., et al. “Nonadherence is associated with late rejection in pediatric heart transplant recipients.J Pediatr, vol. 139, no. 1, July 2001, pp. 75–78. Pubmed, doi:10.1067/mpd.2001.115067.
Ringewald JM, Gidding SS, Crawford SE, Backer CL, Mavroudis C, Pahl E. Nonadherence is associated with late rejection in pediatric heart transplant recipients. J Pediatr. 2001 Jul;139(1):75–78.
Journal cover image

Published In

J Pediatr

DOI

ISSN

0022-3476

Publication Date

July 2001

Volume

139

Issue

1

Start / End Page

75 / 78

Location

United States

Related Subject Headings

  • Treatment Refusal
  • Time Factors
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Outcome Assessment, Health Care
  • Male
  • Immunosuppressive Agents
  • Humans
  • Heart Transplantation