Andersons pediatric cardiology 1789
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FIG.67.27 Kaplan-Meiersurvivalcurvesforprimaryandrepeat
transplants.(FromtheregistryoftheInternationalSocietyofHeartand
LungTransplantation.JHeartLungTransplant.2016;35(10):1185–1195.)
FIG.67.28 Kaplan-Meiersurvivalforretransplantationinchildrenby
intertransplantinterval.(FromtheregistryoftheInternationalSocietyof
HeartandLungTransplantation.JHeartLungTransplant.
2016;35(10):1185–1195.)
FIG.67.29 Kaplan-Meiersurvivalforretransplantationinchildrenby
reasonforretransplantation.(FromtheregistryoftheInternationalSociety
ofHeartandLungTransplantation.JHeartLungTransplant.
2016;35(10):1185–1195.)
ExerciseandAerobicCapacity
Exerciserestrictionisnotusuallynecessaryaftertransplantation,andchildren
shouldbeencouragedtoparticipateinallage-appropriatesportingactivities.
Childrencangenerallyreturntoroutineexerciseoncetheirincisionshave
healed.
Followingtransplantation,physiologicresponsestoexercisemaybeimpaired,
althoughpublisheddataarelimited.Exerciseimpairmentisrelatedtoseveral
factors,includingageattransplantation,87,88deconditioningpriorto
transplantation,degreeofreinnervation,89,90chronotropicincompetence,88,91,92
comorbiditiessuchasrenaldysfunction,respiratoryabnormalities,aswellasthe
effectsofmedicationsuchascorticosteroidsandcalcineurininhibitorson
skeletalmusclefunction.Ingeneral,studiesexaminingexerciseperformancein
childrenhavedemonstratedabluntedresponseofheartratetograded
exercise88,93anddecreasedmaximalconsumptionofoxygen,88,91,93,94although
