CHOLELITHIASIS IN PEDIATRIC CARDIAC TRANSPLANT PATIENTS ON CYCLOSPORINE

From June 1984 to June 1993, symptomatic chlolethiasis was observed in six (6.7%) of 90 cases of pediatric heart or heart-lung transplants a t the authors' institution. The incidence of cholelithiasis for all ch ildren under 16 years of age is estimated to be less than 1%. Previous ly, information on cholelithiasis in pediatric transplant patients on cyclosporine therapy had been limited. Studies concerning the incidenc e of gallstones in adult kidney and cardiac transplant patients have s hown that there is an increase associated with cyclosporine, possibly related to elevated levels and hepatoxicity. Five patients underwent u neventful cholecystectomy. There was only one death, which occurred af ter emergency cholecysostomy tube placement for biliary sepsis. If ind icated, biliary tract surgery can be performed safely in cardiac trans plant patients. The authors report on their experience with symptomati c cholelithiasis in pediatric cardiac transplant patients and review t he current literature on the hepatotoxic effects of cyclosporine. Copy right (C) 1995 by W.B. Saunders Company