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Subclinical cardiovascular changes in pediatric solid organ transplant recipients: A systematic review and meta‐analysis
Author(s) -
Al Nasser Yasser,
Moura Marta C.,
Mertens Luc,
McCrindle Brian W.,
Parekh Rulan S.,
Ng Vicky L.,
Church Peter C.,
Mouzaki Marialena
Publication year - 2016
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12689
Subject(s) - medicine , subclinical infection , transplantation , kidney transplantation , gastroenterology
Abstract CV disease is a major cause of morbidity and mortality following solid organ transplantation in adults. While the prevalence of multiple cardiometabolic risk factors is increased in pediatric solid organ transplant recipients, it is not clear whether they have subclinical CV changes. c IMT , central p WV , and CAC are indicative of subclinical CV disease, and, in adults, predict future CV events. The objective of this systematic review and meta‐analysis was to investigate the prevalence of subclinical CV changes, as measured by c IMT , p WV , and CAC among pediatric solid organ transplant recipients. We searched MEDLINE ® and EMBASE and conducted meta‐analysis for studies that evaluated c IMT , central p WV , and CAC among pediatric solid organ transplant recipients (kidney, lung, intestine and liver). The search identified nine eligible studies that included a total of 259 patients and 685 healthy controls. Eight studies reported on kidney transplant recipients and one study on a combined cohort of kidney and liver transplant recipients. The mean c IMT of transplant recipients was significantly higher than that of healthy controls (mean difference = 0.05 mm, 95% CI 0.02–0.07; p < 0.0001) with an estimated pooled prevalence of elevated c IMT of 56.0% (95% CI 17.0–95.0). The one study that assessed p WV showed increased vascular stiffness in transplant recipients compared to healthy controls. No studies assessing for CAC were found. There were limited data regarding subclinical CV disease following pediatric solid organ transplantation. In conclusion, kidney transplantation in childhood is associated with a higher prevalence of subclinical CV changes compared to healthy children. Longitudinal studies are needed to determine whether children have increased CV morbidity and mortality after transplantation.