Initial Experience with Sildenafil, Bosentan, and Nitric Oxide for Pediatric Cardiomyopathy Patients with Elevated Pulmonary Vascular Resistance before and after Orthotopic Heart Transplantation.pdfVIP

Hindawi Publishing Corporation Journal of Transplantation Volume 2010, Article ID 656984, 6 pages doi:10.1155/2010/656984 Research Article Initial Experience with Sildenafil, Bosentan, and Nitric Oxide for Pediatric Cardiomyopathy Patients with Elevated Pulmonary Vascular Resistance before and after Orthotopic Heart Transplantation Babak Daftari, Juan Carlos Alejos, and Gregory Perens UCLA Medical Center, Mattel Children’s Hospital, Los Angeles, CA 90025, USA Correspondence should be addressed to Babak Daftari, bdaftari@ Received 25 June 2009; Revised 30 September 2009; Accepted 18 January 2010 Academic Editor: Andreas Zuckermann Copyright © 2010 Babak Daftari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Although pulmonary hypertension complicating dilated cardiomyopathy has been shown to be a significant risk factor for graft failure after heart transplantation, the upper limits of pulmonary vascular resistance (PVR) that would contraindicate pediatric heart transplantation are not known. Methods. A retrospective review of all pediatric orthotopic heart transplant (OHT) performed at our institution from 2002 to 2007 was performed. Seven patients with PVR 6 Wood’s units (WU) prior to transplant were compared pre- and postoperatively with 20 matched controls with PVR 6 WU. All pulmonary vasodilator therapies used are described as well as outcomes during the first year posttransplant. Results. The mean PVR prior to transplantation in the 7 study cases was 11.0 ±4.6 (range 6–22) WU, compared to mean PVR of 3.07 ±0.9 WU (0.56–4.5) in the controls