Cardiovascular Risk Assessment in Pediatric Liver Transplant Patients

Abstract

Cardiovascular (CV) diseases play a leading role in the mortality of adult liver transplant (LT) recipients. However, data regarding CV risk factors in children after LT remain sparse. The present study assessed the presence of CV risk factors and signs of CV impairment in LT children.A total of 42 LT recipients (21 males, age 9.93 ± 3.57 years) were studied. Body composition (body mass index SDS score, percentage of body fat (by bioimpedance analysis)), lipid profiles, glycemic control, blood pressure and arterial stiffness (assessed by aortic pulse wave velocity (PWV)) were evaluated. The effect of different treatment modalities (tacrolimus (TAC) (n = 30) or cyclosporine (CyA) (n = 11)) was also analyzed.Almost eighteen % of children were overweight or obese. Patients on TAC had a significantly higher body fat mass and percentage of body fat compared with the CyA group (p < 0.02). Borderline to high lipid values were present in 40% of patients. Children on CyA had higher serum cholesterol levels compared to TAC (p < 0.004). Nineteen percent of patients had hypertension. Half of the patients had GFR values <90 mL/min/1.73m while PWV values were above the 95th percentile in 12%.Increased body fat, chronic kidney disease, high lipid content, hypertension and increased arterial stiffness are already present and are in part related to the type of immunosuppression regimen in LT children more than five years following transplantation. Long-term follow-up is needed to evaluate their impact on CV health and survival.