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De novo aortopathy and cardiovascular outcomes in paediatric liver transplant recipients

Published online by Cambridge University Press:  29 June 2018

James G. Huang ,
Terence Lim ,
Swee-Chye Quek ,
Seng-Hock Quak  and
Marion M. Aw
James G. Huang*
Affiliation:
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
Terence Lim
Affiliation:
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
Swee-Chye Quek
Affiliation:
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
Seng-Hock Quak
Affiliation:
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
Marion M. Aw
Affiliation:
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
*
Author for correspondence: J. G. Huang, Department of Paediatrics, National University Health System, NUHS Tower Block Level 12, 1E Kent Ridge Road, Singapore 119228, Singapore. Tel: 65 6772 4420; Fax: 65 6779 7486; E-mail: james_huang@nuhs.edu.sg
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Abstract

With the increase in long-term survival of post-transplant children, there is a paradigm shift in the emphasis of post-transplant care. We describe de novo cardiovascular abnormalities, which occurred in otherwise asymptomatic paediatric liver transplant recipients, who received liver allografts between 1991 and 2014 at the National University Hospital, Singapore, detected during routine post-transplant monitoring. A total of 96 paediatric liver transplants were performed in 90 children. After transplant, 7/90 (7.8%) recipients were identified with new-onset aortopathy. Glycogen storage disease type I (42.9% versus 2.4%; p<0.001) and recipient Epstein-Barr virus seropositivity (85.7 versus 31.0%, p=0.004) were significant risk factors for aortopathy on univariate analysis. On multivariate analysis, only glycogen storage disease type I remained as the significant risk factor (odds ratio 51.3 [95% confidence intervals: 1.1–2498.1, p=0.047]). Liver transplant is a double-edged sword that reverses certain cardiopulmonary complications of end-stage liver disease but may induce de novo structural cardiac injury in the form of aortic dilation.

Keywords

Liver transplant recipientspaediatricaortopathycardiaccardiovascular
Type
Original Article
Information
Cardiology in the Young , Volume 28 , Issue 8 , August 2018 , pp. 986 - 994
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Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Huang JG, Lim T, Quek S-C, Quak S-H, Aw MM. (2018) De novo aortopathy and cardiovascular outcomes in paediatric liver transplant recipients. Cardiology in the Young28: 986–994. doi: 10.1017/S104795111800063X

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