Postpericardiotomy syndrome during intensive immunosuppression after cardiac transplantation

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.