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High Burden of Subclinical Cardiovascular Target Organ Damage After Pediatric Liver Transplantation
Author(s) -
Memaran Nima,
BorchertMörlins Bianca,
Schmidt Bernhard M. W.,
Sugianto Rizky I.,
Wilke Hannes,
Blöte Ricarda,
Baumann Ulrich,
Bauer Elena,
von Wick Anika,
Junge Norman,
Leiskau Christoph,
Pfister Eva D.,
ThurnValsassina Daniela,
Richter Nicolas,
Goldschmidt Imeke,
Melk Anette
Publication year - 2019
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.25431
Subject(s) - medicine , subclinical infection , pulse wave velocity , cardiology , dyslipidemia , body mass index , liver transplantation , renal function , transplantation , blood pressure , gastroenterology , obesity
Cardiovascular (CV) events account for 8%‐13% of deaths after liver transplantation (LT) in adulthood. Although CV risk factors (RFs) are present, little is known about the prevalence of subclinical CV target organ damage (TOD) in children after LT. The aim of this prospective observational study was to assess the prevalence of subclinical CV TOD in children after LT and to identify RFs contributing to CV damage as potential targets for clinical intervention. In this study, 104 children after LT (54% female, 46% male; aged 11.5 ± 3.8 years) underwent cross‐sectional assessment of subclinical TOD by carotid‐femoral pulse wave velocity (PWV), carotid intima‐media thickness (IMT), and left ventricular mass index (LVMI). Results were correlated with the presence of CV RFs (obesity, hypertension, dyslipidemia, renal impairment, anemia, and microinflammation). Of the patients, 22% were exposed to 2 CV RFs, and 36% displayed 3 or more CV RFs. Pathological results for PWV, IMT, and LVMI were found in 21.9%, 57.0%, and 11.1% of patients, respectively. In the multivariate analysis, diastolic blood pressure ( P = 0.01) and estimated glomerular filtration rate (eGFR; P = 0.03) were independently associated with PWV, eGFR ( P = 0.005), and age at LT ( P = 0.048) with IMT and body mass index with LVMI ( P = 0.004). In conclusion, patients after pediatric LT carry a substantial burden of subclinical CV TOD. Identification of modifiable CV RFs opens opportunities for targeted intervention in order to reduce CV morbidity and mortality in the future.