Cardiac dysfunction after renal transplantation; incomplete resolution in pediatric population.
BACKGROUND
Long-term data of cardiac function after renal transplantation (RT) are limited, especially in children. Thus, we evaluated the status of left ventricular hypertrophy and various indices of left ventricular (LV) function in pediatric RT patients.


METHODS
Blood pressure, serum biochemical profiles, electrocardiogram, and echocardiogram of 32 pediatric patients (mean age, 15.5+/-4.4 years) who underwent RT 5.1+/-2.5 years before and 29 body surface area-matched control subjects were studied.


RESULTS
Repolarization abnormalities shown on electrocardiogram of pre-RT patients improved significantly after RT (QTc dispersion 50.8+/-37.3 to 37.4+/-11.9 msec, P=0.009). Left ventricular hypertrophy with increased LV mass index of pre-RT patients regressed remarkably after RT (LV mass index 120.9+/-40.5 to 69.2+/-14.5 g/m2, P<0.001); still, LV mass was significantly higher in RT patients than the controls (54.0+/-9.6 g/m2, P<0.001). Compared with the controls, the RT patients showed diastolic dysfunction (lower E/A ratio and higher isovolumic relaxation time) and lower myocardial performance (higher LV Tei index and weaker strain pattern). Patients who had shorter duration of non-RT renal replacement therapy showed better LV function (lower LV Tei index and stronger strain pattern) in the long-term follow-up.


CONCLUSIONS
Because cardiac dysfunction did not resolve after RT in pediatric population, regular evaluation for cardiovascular function after RT is required. Early RT may also be beneficial to global LV performance after RT.
Kim
Gi Beom
GB
Department of Pediatrics, Seoul National University Hospital, Jongno-Gu, Seoul, South Korea.
Kwon
Bo Sang
BS
Kang
Hee Gyung
HG
Ha
Jong Won
JW
Ha
Il Soo
IS
Noh
Chung Il
CI
Choi
Jung Yun
JY
Kim
Sang Joon
SJ
Yun
Yong Soo
YS
Bae
Eun Jung
EJ
D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D003971:Diastole; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology* / Q000706:statistics & numerical data; D007723:Korea / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology*; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult