Induction immunotherapy in pediatric heart transplant recipients: a multicenter study

Infection and malignancy after pediatric heart transplantation: The role of induction therapy

“…Whether this is related to changing patterns of maintenance immunosuppression or a transition in induction agent used is unclear. Nevertheless, this finding parallels that of previous adult studies 12,16 and data reported by Boucek et al, 4 who cited a similarly low frequency of PTLD in a smaller group of induced pediatric patients.…”

“…Nonetheless, the argument that lower cumulative intensity of immunosuppressive therapy (ie, induction followed by lower-dosed maintenance regimens and less frequent rejection treatments) might be inversely linked to PTLD risk would be indirectly supported by our data and congruent with the general interpretation of previous investigators. 4,16,31,36 Slightly more than 30% of our patients experienced an early infection. Although CHD was an independent risk factor for early fungal infections perhaps related to comorbid conditions and associated post-surgical complications, induction did not increase the risk of infection, particularly fungal or CMV, results corroborated by previous studies that identified no correlation between induction and infection risk when comparing OKT3/ATG with no induction 4,6,13 or IL-2R antagonists with ATG or a placebo control group.…”

Decline in rejection in the first year after pediatric cardiac transplantation: A multi-institutional study

“…Prior studies from the PHTS have shown a decrease in mortality with induction therapy, without an increase in malignancy. 37 Although this association is intriguing, it remains to be seen whether there will be a commensurate increase in the incidence of complications such as PTLD and serious infections in the patients who received induction treatment.…”

Does Cytomegalovirus Serology Impact Outcome After Pediatric Heart Transplantation?

“…A similar approach was previously undertaken in another PHTS investigation analyzing the impact of induction therapy and patient survival. 7 Clinical CMV infection is recorded in the annual follow-up form for the study subjects. The PHTS data form defines infection as "infectious process requiring IV therapy or a life threatening infection requiring oral therapy.…”