Cardiovascular risk factors and cardiac disorders in long-term survivors of pediatric liver transplantation.
The MetS and cardiovascular disease are leading causes of late morbidity in adult liver transplantation recipients; however, limited data are available in pediatric liver transplantation. A single-center retrospective review was undertaken for patients who had a liver transplantation before 18 yr of age and were >5 yr post-transplantation, to study the prevalence of MetS, its components, and cardiac disorders. Fifty-eight patients were included in the study with a mean age at transplantation of 6.3 ± 6.1 yr and mean follow-up of 14.1 ± 6.0 yr. Of the study group, 41.4% were overweight or obese, with ongoing prednisone use and increased duration of follow-up being significant risk factors. Fifty-three patients had sufficient data for determining MetS, which was present in 17% of the patients. Although the prevalence of MetS is low in pediatric liver transplant recipients, it is associated with CKD and prednisone therapy (p < 0.05). Echocardiography data were available for 23 patients, of whom 43.4% had LVH and 13% had evidence of PH. The spectrum of cardiac disorders in this population is much wider than in adults.
Department of Pediatrics, Cleveland Clinic, Cleveland, OH, USA.
Shankar
S
Baskar
Peggy L
PL
George
Bijan
B
Eghtesad
Kadakkal
K
Radhakrishnan
Vera
V
Hupertz
Peter F
PF
Aziz
Naim
N
Alkhouri
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors
hepatopulmonary syndrome; left ventricular hypertrophy; liver transplantation; metabolic syndrome; pediatrics; pulmonary hypertension