Effect of age on lipid profiles in pediatric heart transplant recipients.
This study's objectives were to determine if pediatric orthotopic heart transplant (OHT) recipients over all ages develop hyperlipidemia and, secondarily, to identify the effects of immunosuppressive agents and statins on lipid profiles in these patients. Retrospective chart review was performed for pediatric patients transplanted between January 1987 and June 2002. Of the 100 OHTs performed, 50 patients satisfied the inclusion criteria and were grouped by age at OHT as follows: group 1 (n = 16): 0-4 yr; group 2 (n = 10): 5-9 yr; group 3 (n = 15): 10-14 yr; group 4 (n = 9): 15-18 yr. There were 2789 lipid levels recorded, and each patient had an average of 14 post-OHT lipoprotein panels measured. Post-OHT total cholesterol and low-density lipoprotein (LDL) levels were significantly greater than those of the general population for the entire follow-up period in all age groups, except for LDL levels in group 2. Cyclosporin level and prednisone dose were positively associated with total cholesterol and LDL levels (p < 0.03). Statins significantly decreased total cholesterol and LDL levels (p < 0.001). Hyperlipidemia affects OHT patients of all ages. Even the youngest patients may benefit from immunosuppression using an alternative to cyclosporin, such as tacrolimus, and steroid-free regimens, which may improve lipid profiles. Once safety and efficacy data are available, all age groups may benefit from statins.
Armstrong
Aimee K
AK
Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI 48109, USA. aimeearm@umich.edu
Goldberg
Caren S
CS
Crowley
Dennis C
DC
Wei
Wei
W
Gajarski
Robert J
RJ
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000209:etiology*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones; D000960:Hypolipidemic Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011241:Prednisone