title: Anthropometric growth and utilization of enteral feeding support in pediatric heart transplant recipients.
abstract: We sought to outline trends in anthropometric growth before and after cardiac transplantation and to document our experience with the use of EFS in this population. A total of 130 patients (59% male) were enrolled and followed for a median of 4.4 yr after transplantation. Negative changes over time in weight z-score (EST: -0.256 [0.160] z/yr, p = 0.01), height z-score (EST: -0.214 [0.096] z/yr, p = 0.03), and BMI z-score (EST: -0.287 [0.161] z/yr, p = 0.07) were observed prior to transplantation. Significant increases in weight z-score (EST: +0.342 [0.143] z/yr, p < 0.001) and BMI z-score (EST: +0.396 [0.140] z/yr, p = 0.005) were seen in the first 18 months following transplantation. No further increases in height, weight, or BMI z-score were seen beyond this. Forty-two (32%) patients received EFS. Prior to transplantation, it was not found to be associated with change in anthropomorphic growth. Post-transplantation exposure to EFS was associated with a faster increase in weight z-score (EST: +0.480 [0.231] z/yr, p = 0.04) and height z-score over time (EST: +0.366 [0.141] z/yr, p = 0.01). Normalization of weight and height z-scores was not achieved during the study follow-up period. This study suggests that further investigation into the role of EFS is warranted to identify strategies to improve growth in pediatric heart transplant recipients.
authors.affiliation: Labatt Family Heart Centre, SickKids Transplant Centre, The Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada. louise.bannister@sickkids.ca
authors.forename: Louise
authors.initials: L
authors.lastname: Bannister
authors.forename: Cedric
authors.initials: C
authors.lastname: Manlhiot
authors.forename: Stacey
authors.initials: S
authors.lastname: Pollock-BarZiv
authors.forename: Tanya
authors.initials: T
authors.lastname: Stone
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
authors.forename: Anne I
authors.initials: AI
authors.lastname: Dipchand
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D049628:Body Size; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006128:Growth; D006321:Heart / Q000502:physiology*; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics / Q000379:methods*; D015430:Weight Gain; D055815:Young Adult