title: Pediatric post-transplant metabolic syndrome: new clouds on the horizon.
abstract: Liver transplantation (LT) is a standard treatment for children with end-stage liver disease, standing at more than 90% survival rate after one yr, and at over a 70% survival rate after five yr. The majority of transplanted children enjoy an excellent quality of life but complications can occur in the long term, and can develop subclinically in otherwise well children; there are various underestimated nutritional and metabolic aspects, including the so-called post-transplant metabolic syndrome (PTMS). During the post-transplant period, the use of immunosuppressants, corticosteroids, calcineurin inhibitors, and the presence of risk factors, including non-alcoholic fatty liver disease (NAFLD), and kidney and bone complications have been largely implicated in PTMS development. Strategies to reduce the progression of PMTS should include careful screening of patients for diabetes, dyslipidemia, and obesity, and to support weight reduction with a carefully constructed program, particularly based on diet modification and exercise. With early identification and appropriate and aggressive management, excellent long-term health outcomes and acceptable graft survival can be achieved.
authors.affiliation: Department of Paediatric Surgery and Transplantation Center, Bambino Gesù Children's Hospital, Roma, Italy. nobili66@yahoo.it
authors.forename: Valerio
authors.initials: V
authors.lastname: Nobili
authors.forename: Jean
authors.initials: J
authors.lastname: de Ville de Goyet
mesh_terms: D000293:Adolescent; D002648:Child; D048909:Diabetes Complications; D018450:Disease Progression; D058625:End Stage Liver Disease / Q000628:therapy*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology*; D009765:Obesity; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents