Rejection is a leading cause of morbidity in pediatric heart transplant
recipients, often through progression to graft failure and death. In the most
recent era, 15% of patients experienced treated rejection within the first yearpost-transplant, with rates of rejection being highest in patients greater than
1 year of age.
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| Pediatric Heart Transplant |
Frequent monitoring with cardiac catheterization and endomyocardial
biopsy (EMB) has been utilized to monitor patients in the post-transplant period
for evidence of rejection. However, EMB has been associated with risks such as
tricuspid valve damage and regurgitation, conduction system abnormalities, and
cardiac perforation. Endomyocardial biopsy is subject to sampling error and
inter-observer variability, and can only detect acute cellular rejection (ACR)
once cellular infiltration and damage has occurred.
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