Lipid profile and cardiovascular risk factors in pediatric liver transplant recipients

Pediatr Transplant. 2016 Mar;20(2):241-8. doi: 10.1111/petr.12664. Epub 2016 Jan 11.

Abstract

Cardiovascular diseases induce long-term morbidity and mortality of adult LT recipients. The aim of this retrospective study was to assess CVRF, lipid abnormalities, and atherosclerosis (appraised by c-IMT), more than 10 yr after pediatric LT. Thirty-one children who underwent LT between December 1990 and December 2000 were included. Median age at LT was 14 months (range 4-64), and median follow-up after LT was 11.9 yr (range 9.0-17.3). In our cohort, obesity (9.7%) and treated hypertension (9.7%) were rare. None of the patients was smoker or diabetic. High TC and TG were both observed in 6.5% of the patients. The mean c-IMT for male patients was 1.22 ± 1.55 and 1.58 ± 1.23 mm in female patients. Seven patients (22%) had a mean c-IMT above +2 s.d. Values below the 5th percentile were noted for LDL-cholesterol (58.1%), HDL-cholesterol (25.8%), apolipoprotein B (40%), and apolipoprotein A1 (20%). LDL-cholesterol and apolipoprotein B levels were significantly lower in patients treated by tacrolimus in comparison with CsA (p < 0.05). In conclusion, our results suggest that pediatric LT patients do not present significant CVRF; moreover, instead of hyperlipidemia, hypocholesterolemia (LDL-C) is frequent and immunosuppressive therapy is probably the cause.

Keywords: outcome; pediatric liver transplantation.

MeSH terms

  • Adolescent
  • Apolipoprotein A-I / blood
  • Apolipoproteins B / blood
  • Biopsy
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / complications
  • Child
  • Child, Preschool
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cyclosporine / therapeutic use
  • Dyslipidemias / complications
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Liver / pathology
  • Liver Failure / blood*
  • Liver Failure / complications
  • Liver Failure / surgery
  • Liver Transplantation*
  • Male
  • Retrospective Studies
  • Risk Factors
  • Tacrolimus / therapeutic use
  • Transplant Recipients
  • Treatment Outcome

Substances

  • Apolipoprotein A-I
  • Apolipoproteins B
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Immunosuppressive Agents
  • Cyclosporine
  • Tacrolimus