Growth and weight gain of prepubertal children after cardiac transplantation

Area of Science:

• Pediatric Cardiology
• Transplantation Medicine
• Growth and Development

Background:

• Pediatric heart transplantation (OHT) is a life-saving procedure.
• Understanding post-transplant growth is crucial for long-term patient outcomes.
• Somatic growth changes, including weight, height, and BMI, require careful monitoring after OHT.

Purpose of the Study:

• To evaluate changes in weight, height, and BMI Z scores after pediatric heart transplantation.
• To identify factors influencing somatic growth changes in children post-OHT.
• To assess the long-term impact of OHT on growth parameters.

Main Methods:

• Retrospective evaluation of 46 pediatric heart transplant recipients (<11 years old).
• Analysis of changes in weight, height, and BMI Z scores at baseline and up to two years post-transplant.
• Multivariate analysis to identify predictors of growth changes, including steroid treatment duration and age at transplant.

Main Results:

• Significant increases in weight and BMI Z scores were observed at six months post-OHT (p < 0.001).
• No significant changes in height Z scores were noted at six months, one year, or two years post-OHT.
• 17% of patients became overweight (BMI Z score > 2) within two years; steroid treatment duration predicted negative height change, while younger age at transplant predicted positive height change.

Conclusions:

• Pediatric heart transplant recipients show significant weight and BMI gain but limited linear growth catch-up.
• Increased BMI post-transplant can lead to overweight and obesity, necessitating monitoring.
• Steroid therapy duration and age at transplant are key factors influencing post-transplant linear growth.