Serum lipids in children 3 to 5 years after kidney, liver, and heart transplantation

Abstract

Although dyslipidaemia is common after solid organ transplantation (Tx), there are few long-term studies in children. We investigated the prevalence of dyslipidaemia up to 5 years after Tx in 125 children on triple immunosuppression with one of three different well-functioning grafts, kidney, liver, and heart, and 181 controls. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) concentrations were measured annually. Low-density lipoprotein cholesterol concentrations were also calculated. The risk factors for dyslipidaemia were determined at 3 years. There was a high prevalence of hypertriglyceridaemia in all three groups, 50% in the kidney transplantation (KTx) and heart transplantation (HTx) groups and 30% in the liver transplantation (LTx) group. In addition, 50% of KTx patients had high TC. In the Tx groups taken together, the following independent associations were observed: KTx and high pre-Tx TC were associated with high TC, high trough concentration of blood cyclosporine with low HDL-C, and older age at Tx accounted for higher TG. Dyslipidaemia, especially hypertriglyceridaemia, was common 3-5 years after Tx. The aetiology is multifactorial and depends on the transplanted organ.

Cardiorespiratory fitness is a marker of cardiovascular health in renal transplanted children

“…Four children in our study fulfilled the criteria for the metabolic syndrome, a figure that is much lower than that reported in a recent study [56]. A more favorable lipid profile post-TX compared with several other studies [57][58][59], could result in fewer children meeting 3 of the 5 criteria of the metabolic syndrome constellation.…”

Cholesterol Absorption and Synthesis in Pediatric Kidney, Liver, and Heart Transplant Recipients

“…Patients with GFR below 40 ml/min/ 1.73 m 2 were considered to have changes in their lipid parameters due to renal insufficiency and were excluded from the study. Our immunosuppressive protocol with CsA, MP, and azathioprine has been described in detail previously (6). The mean follow-up period after transplantation at the time of the study was 5.3 years (range 1-11 years), 6.4 years (range 1-11 years), and 2.7 years (range 1-7 years) in the groups of kidney, liver, and heart transplant recipients, respectively.…”

“…Impaired kidney function or proteinuria, immunosuppressive and other medications are thought to cause alterations in lipid metabolism. Previously, we have reported a high prevalence of hypertriglyceridemia in pediatric kidney, liver, and heart transplant recipient groups and higher serum total cholesterol (TC) concentrations in kidney than in liver or heart transplant recipients, or controls (6). Patients in each transplant recipient group were on similar triple immunosuppression [cyclosporine (CsA), methylprednisolone (MP), and azathioprine].…”

Cure of multifocal panhepatic hepatoblastoma: is liver transplantation always necessary?

“…On the other hand, although the results of pediatric LT have regularly improved and nowadays reach 95% 3-year patient survival [40], growing concern appears regarding the long-term outcome of these patients: in the current state of knowledge, lifelong immunosuppression is needed for most children, and a wide range of potential long-term complications are possible, including impairment of renal function [41][42][43]; dyslipidemia [44][45][46][47]; lymphoproliferative disorders; and other de novo tumors [48][49][50][51], infections [52][53][54], and chronic and late acute rejection [10,55]. In the current recommended treatment of multinodular panhepatic HBs by total hepatectomy and LT, these possible long-term sequelae are the counterpart for the increased rate of patients whose disease can be cured.…”