July 28, 2020

Post-transplant complication

Vanderbilt researchers conducted the largest analysis to date of a heart complication in children following stem cell transplant. The findings may help guide screening practices to improve outcomes.

by Leigh MacMillan

Hematopoietic stem cell transplantation (HSCT) is a curative treatment for many children with both malignant and non-malignant conditions. Pericardial effusion — excess fluid around the heart — is a recognized complication following HSCT, but its incidence, risk factors and impact on mortality are not well defined. 

Carrie Kitko, MD, Justin Godown, MD, and colleagues used the Pediatric Health Information System, an administrative database including more than 50 tertiary hospitals, to assess incidence, risk factors and outcomes of children with pericardial effusion following HSCT. 

They found that of 10,455 included patients, 7.1% developed pericardial effusion a median of 69 days post-transplantAllogeneic transplant patients who developed pericardial effusion (9.1%) had worse survival than those without the complication. 

The researchers identified risk factors associated with post-transplant pericardial effusion, including thrombotic microangiopathy and other cardiac symptoms. 

The findings, reported in the journal Pediatric Transplantation, may help guide screening practices for pericardial effusion to improve outcomes for children following HSCT.

This research was supported by the National Institutes of Health (grant CA068485).