Background: Cardiovascular morbidity is common in adults after lung transplantation (LTx) but has not been described for pediatric LTx recipients. Early subclinical cardiovascular damage is reflected by increases in pulse wave velocity (PWV; indicating arteriosclerosis), intima-media thickness (IMT; indicating atherosclerosis), and left ventricular mass index (LVMI; indicating left ventricular hypertrophy).
Methods: We annually assessed 47 pediatric LTx recipients in a prospective longitudinal study (144 observations, mean 3.1 visits/patient, range of 1-4 visits, mean follow-up 2.2 y).
Results: At inclusion, increased PWV and IMT were detected in 13% and 30%, respectively, and elevated LVMI was detected in 33%. Higher PWV was associated with male sex, longer time since LTx, higher diastolic blood pressure, and lower glomerular filtration rate. Male sex and lower hemoglobin levels were associated with higher IMT, and the presence of diabetes was associated with higher LVMI.
Conclusions: Pediatric LTx recipients suffer from a high and sustained burden of subclinical cardiovascular damage. In light of improving long-term outcomes, cardiovascular morbidity needs to be addressed. Our analysis identified classical and nonclassical risk factors to be associated with the measures for cardiovascular damage, which could serve as targets for intervention.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/TP.0000000000004025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The assessment of myopenia and muscle biopsy in pediatric patients with liver disease awaiting liver transplantation - A cross-sectional analysis.
Liver Transpl
October 2024
Department of Agricultural, Food & Nutritional Sciences, University of Alberta.
Little is known about the skeletal muscle characteristics (fibre type proportion and size, location of nuclei, presence of fat infiltration) in children with liver disease with radiologically determined myopenia (low muscle mass). During liver transplantation (LTx) surgery, biopsies from the rectus abdominis muscle were collected. Muscle fibre types (I, I/IIA, IIA, IIA/X, IIX) and CSA index (µm/m2) were determined using immunofluorescence staining.
View Article and Find Full Text PDFTime to Rethink Bronchiolitis Obliterans Syndrome Following Lung or Hematopoietic Cell Transplantation in Pediatric Patients.
Cancers (Basel)
November 2024
Division of Nursing, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kwei-Shan, Taoyuan 33315, Taiwan.
Article Synopsis
- Bronchiolitis obliterans syndrome (BOS) can occur after lung or hematopoietic cell transplantation, with HCT-related graft-versus-host disease being a key factor in diagnosis and treatment difficulties.
- Current treatments for BOS are mainly empirical due to the lack of proven effective medications, highlighting the need for cross-disciplinary collaboration and the investigation of new therapies.
- Ongoing research aims to improve understanding of BOS, and there are promising novel treatments being explored, including aerosolized liposomal cyclosporine and Janus kinase inhibitors, to enhance survival rates and reduce the need for lung transplantation.
Role of percutaneous transhepatic biliary drainage for managing bile lake formation after Kasai portoenterostomy.
Pediatr Surg Int
October 2024
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Purpose: Bile lake (BL) formation following Kasai portoenterostomy (KPE) can complicate the prognosis of biliary atresia (BA). Percutaneous transhepatic biliary drainage (PTBD) performed under fluoroscopic/ultrasonographic (US) guidance is discussed for the management of BL.
Methods: A retrospective review of 64 BA patients treated by KPE (open = 31, laparoscopic = 33) at a single center (2004-2023) identified 9 BL cases (9/64; 14.
Cardiac Comorbidity and Exercise Intolerance in Bilateral Lung Transplant Recipients Followed at a Pediatric Center.
Pediatr Cardiol
October 2024
Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Reduced exercise capacity is common in young bilateral lung transplantation (Bi-LTx) recipients, but longer-term data on cardiac comorbidities are limited. We evaluate potential cardiac contributions to long-term exercise intolerance in this population. All Bi-LTx recipients at a single pediatric center, who completed routine clinical post-transplant cardiac assessment, including echocardiogram, cardiac exam, and cardiopulmonary exercise testing (CPET), were included.
View Article and Find Full Text PDFDiagnostic alignment to optimize inter-rater reliability among lung transplant pathologists.
J Heart Lung Transplant
October 2024
Division of Allergy and Pulmonary Medicine, Washington University in St. Louis, St. Louis, Missouri.
Article Synopsis
- Poor agreement among lung transplant pathologists in assessing rejection has been noted, making inter-rater reliability crucial for effective patient care and clinical trial inclusion criteria.
- A survey and diagnostic sessions with nine pathologists from eight centers evaluated their practices and scoring of high-risk histopathologic findings related to chronic lung allograft dysfunction (CLAD).
- The results showed good inter-rater reliability for identifying high-risk findings after these alignment sessions, indicating that collaborative discussions improved consensus among pathologists.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!