Long-term follow-up of pediatric heart transplant patients

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Heart transplantation has become an important intervention for some congenital and acquired cardiac problems. In order to maximize outcome, it is important to understand both short and long-term complications related to the transplant and the anti-rejection regimens that must be implemented to maintain it. In this issue of The Journal, Kulikowska et al reviewed the clinical course of cardiac transplant survivors after 5 years from transplantation. They found that recipients during infancy had higher long-term rates of severe and chronic infections compared with older recipients. In addition, autoimmune disorders occurred in 18% of infants, most commonly autoimmune cytopenias. The frequency of these autoimmune disorders was previously unrecognized in patients after heart transplantation. These results will help pediatricians work in better partnership with the members of the transplant clinical team to provide optimum long-term outcomes.