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• W2334131063 abstract "Introduction: Thymus transplantation can successfully reconstitute immune status of infants with complete DiGeorge anomaly. For several months after transplantation, these infants remain immunodeficient and are at risk for admission to the pediatric intensive care unit (PICU). Our objective was to identify risk factors for PICU admission and mortality in infants following thymus transplantation. Hypothesis: Age at transplantation and congenital heart disease (CHD) are risk factors for PICU admission and mortality. Methods: We reviewed medical records and collected data for infants evaluated for thymus transplantation between 1993 and 2010. We examined all emergent PICU admissions for 6 months after transplantation (excluding elective admissions). Primary outcome was survival to PICU discharge. Wilcoxon rank-sum test and Fisher exact test were used for analysis. Results: Sixty nine infants were referred for thymus transplantation, and 60 were transplanted. Median age at transplantation was 5.2 months (Range: 1.1-22.1). After transplantation, 13/60 infants (22%) required 26 emergent PICU admissions. Median time from transplantation to first PICU admission was 24.5 days (Range: 4-111). In 16/26 admissions (62%), intubation and mechanical ventilation were necessary, with 56% of these admissions being supported with high frequency ventilation (HFV). The need for HFV was associated with increased PICU mortality (Odds ratio (OR): 22.8, 95%CI: 1.83–642.7). One infant required extracorporeal membrane oxygenation for refractory respiratory failure. Median duration of PICU stay was 12 days (Range: 1-63). Eight (62%) infants survived to PICU discharge, with 7 surviving to 6 months post-transplantation. Forty three (72%) infants transplanted had CHD, and 10/13 (77%) who were admitted to the PICU had CHD. Presence of CHD had no impact on risk for PICU admission (OR: 1.4, 95%CI: 0.33 – 6.311) or mortality (OR 0.28, 95%CI: 0.03-2.45). Age at transplantation was also not a risk factor for PICU admission (OR: 1.01, 95%CI: 0.89-1.16) or mortality (OR: 0.94, 95%CI: 0.79-1.12). Conclusions: This report is the first description of infants with DiGeorge anomaly admitted to the PICU following thymus transplantation. Most transplanted infants did not require emergent PICU admission, but in infants requiring PICU admission, the need for HFV was associated with increased mortality, while age at transplantation and presence of CHD were not associated with PICU admission or mortality." @default.
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• W2334131063 date "2012-12-01" @default.
• W2334131063 modified "2023-09-27" @default.
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• W2334131063 doi "https://doi.org/10.1097/01.ccm.0000424906.94649.45" @default.
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