title: Cardiovascular risk factors after conversion from cyclosporine to tacrolimus in children after liver transplantation.
abstract: BACKGROUND
  Calcineurin inhibitors (CNI) may increase the risk of cardiovascular (CV) events. This prospective study aimed to determine cardiovascular risk factors in pediatric patients after living related liver transplantation (LRLTx) 12 months after the conversion from cyclosporine (CS) to tacrolimus (TAC).
  
  
  METHODS
  The study group consisted of 7 children (5 females and 2 males) after LRLTx performed at the median age of 3 years (range 0.8-7.2), who received CS monotherapy for at least 5 years before it was switched to TAC. The median age at conversion was years 13.1 years (range 10.1-18). Weight BMI Z-score, 24-h ABPM (ambulatory blood pressure monitoring), renal function assessment, and fasting lipid and oxidative stress profiles were performed before and 12 months after conversion.
  
  
  RESULTS
  Within 1-year follow-up, TAC was well tolerated and we did not observe any drug-related adverse effects or severe infections. Renal function, blood pressure, and lipid parameters did not differ after the conversion. Before the conversion, there was lower median glutathione (GSH) levels (748 vs. 776 [µmol/l]) and glutathione peroxidase (GPx) activity (31.4 vs. 32.4 [U/gHb]), but statistical significance was not reached (p>0.05). Asymmetric dimethylarginine (ADMA) levels were higher before conversion to TAC (0.93 vs. 0.69 [µmol/l], p=0.01), as were oxidized LDL (oxyLDL) levels (317 vs. 264 [mU/ml], p=0.04).
  
  
  CONCLUSIONS
  There was no significant difference between CS and TAC in risk factors for CV events. Potential benefits in oxidative stress profile resulting from CS to TAC conversion may add another important area for further research.
authors.affiliation: Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czubkowski
authors.affiliation: Department of Biochemistry and Experimental Medicine, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Aldona
authors.initials: A
authors.lastname: Wierzbicka
authors.affiliation: Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Socha
authors.affiliation: Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Irena
authors.initials: I
authors.lastname: Jankowska
authors.affiliation: Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Pawłowska
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus