Obesity and dyslipidemia predict cardiac allograft vasculopathy and graft loss in children and adolescents post-heart transplant: A PHTS multi-institutional analysis.
Document Type
Article
Publication Date
8-2022
Identifier
DOI: 10.1111/petr.14244
Abstract
BACKGROUND: Obesity and dyslipidemia afflict children of all ages. We explored the prevalence of obesity and dyslipidemia in pediatric heart transplant (HT) recipients and its effects on cardiac allograft vasculopathy (CAV) and survival.
METHODS: This study included primary HT recipients (≤18 years) transplanted between 01/1996 and 12/2018 included in the Pediatric Heart Transplant Society database. Obesity was categorized according to WHO/CDC guidelines and dyslipidemia according to the National Cholesterol Education Program. Kaplan-Meier analyses for CAV and graft loss stratified for BMI and lipid panels were generated and risk factors identified using multivariate analyses.
RESULTS: Among 6291 HT patients (median age [range] at HT = 4.3 [0.6-12.8] years; 45% Female; 68% White), 56% had a normal BMI at HT. Obese patients at HT had an increased risk for graft loss (HR 1.19, 95% CI 1.01-1.4, p = .04). Poor total cholesterol (TC), LDL-C, and TG were associated with the risk of both CAV (HR 1.79, p < .0001; HR 1.65, p = .0015; HR 1.53, p < .0001, respectively) and graft loss (HR 1.58, p = .0008; HR 1.22, p = .04; HR 1.43, p = .0007, respectively).
CONCLUSIONS: Pediatric patients who are obese at the time of HT and dyslipidemic at 1 year post-HT are at an increased risk for CAV and graft loss. Preventative interventions may reduce morbidity and mortality among this cohort.
Journal Title
Pediatric transplantation
Volume
26
Issue
5
First Page
14244
Last Page
14244
MeSH Keywords
Adolescent; Allografts; Child; Child, Preschool; Dyslipidemias; Female; Graft Rejection; Heart Diseases; Heart Transplantation; Humans; Male; Obesity; Retrospective Studies; Risk Factors
Keywords
CAV; PHTS; Pediatric heart transplant; cardiometabolic; dyslipidemia; obesity; preventative
Recommended Citation
Bogle C, Cantor R, Koehl D, et al. Obesity and dyslipidemia predict cardiac allograft vasculopathy and graft loss in children and adolescents post-heart transplant: A PHTS multi-institutional analysis. Pediatr Transplant. 2022;26(5):e14244. doi:10.1111/petr.14244
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