A 15-year-old man with end-stage heart failure due to dilated cardiomyopath
y, underwent heart transplantation. In the second postoperative week, while
being treated with monoclonal antibodies (OKT3), cyclosporine and azathiop
rine, he developed a postpericardiotomy syndrome and cardiac tamponade, whi
ch necessitated emergency pericardiocentesis. Corticosteroids, administered
according to the immunosuppression protocol, resulted in the prompt subsid
ence of the syndrome. This is the first report of a large pericardial effus
ion and cardiac tamponade due to a postpericardiotomy syndrome in an adult
cardiac recipient.