PP.38.24: CARDIOVASCULAR CHANGES AND LIPID PROFILE IN CHILDREN AFTER LIVER TRANSPLANTATION. (June 2015) - Antoniewicz, J.
Abstract : Objective: Patients after liver transplantation (LTx) are potentially at increased risk of cardiovascular complications due to long-term immunosupression. In adults this is an important cause of morbidity and mortality. The aim of the study was to estimate the risk of cardiac events in long-term pediatric liver transplant recipients with special focus on subclinical atherosclerosis. Design and method: In 25 patients (21 girls) at the mean age of 15, 5 years (range 12–18) and at least 8 years (range 8–16) after LTx with stable graft function and no significant post-transplant complications for at least 6 months we measured carotid intima-media thickness (cIMT), relative wall thickness (RWT), left ventricular mass index calculated according to the de Simone formula (LVMi-S), 24-hour ambulatory blood pressure monitoring (ABPM). Laboratory assessment comprised: lipid profile (triglycerides, cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), very low-density cholesterol (VLDL)). These parameters were compared with age matched healthy controls: n = 33, mean age 15, 5 years (12–18). Results: BMI Z-score did not differ between groups however 90th percentile was exceeded in 5 patients after LTx. CIMT was normal in all patients according to age percentiles, mean 0, 4 mm (range 0, 35–0, 42). Mean RWT was 0, 35 (0, 22–0, 54) and was abnormal in 5 patient (20%). Mean LVMi-S was 28, 1 g/m2.7 (18, 5–40, 6), abnormal in 2 (8%). All patient were normotensive according to ABPM. Lipids were not significantly disturbed in the study group: cholesterol 136 ± 22 mg/dl, triglycerides 84 ± 47 mg/dl, HDL 44 ± 11 mg/dl, LDL 78 ± 19 md/dl, VLDL 12, 6 ± 4, 8 mg/dl. Conclusions: Although cardiovascular changes and markers of atherosclerosis are not significantly disturbed, children after liver transplantation present with higher risk of cardiovascular complications and cardiac follow-up is mandatory especially in adolescence before transition to adult care.