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Published on: September 21, 2021
Anthropometric growth and utilization of enteral feeding support in pediatric heart transplant recipients
Louise Bannister1, Cedric Manlhiot, Stacey Pollock-BarZiv
1Labatt Family Heart Centre, SickKids Transplant Centre, The Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada. louise.bannister@sickkids.ca
Insights
Pediatric heart transplant recipients experienced declining growth before transplantation, with significant improvements in weight and BMI within 18 months post-transplant. Enteral formula supplementation (EFS) appeared to enhance post-transplant growth, warranting further study.
Area of Science:
- Pediatric Cardiology
- Transplantation Medicine
- Growth and Development
Background:
- Pediatric heart transplant recipients often face challenges with anthropometric growth.
- Understanding growth trajectories and the impact of interventions like enteral formula supplementation (EFS) is crucial.
Purpose of the Study:
- To analyze anthropometric growth trends in pediatric patients before and after cardiac transplantation.
- To evaluate the association of enteral formula supplementation (EFS) with growth outcomes in this population.
Main Methods:
- Retrospective analysis of 130 pediatric heart transplant recipients.
- Tracking weight, height, and BMI z-scores pre- and post-transplantation.
- Assessing the impact of EFS exposure on growth parameters.
Main Results:
- Pre-transplant growth showed negative trends in weight, height, and BMI z-scores.
- Significant increases in weight and BMI z-scores were observed in the first 18 months post-transplant.
- EFS exposure post-transplant was associated with accelerated weight and height z-score increases, though normalization was not achieved.
Conclusions:
- Pediatric heart transplant recipients exhibit distinct growth patterns pre- and post-transplantation.
- Enteral formula supplementation may play a beneficial role in improving post-transplant growth.
- Further research is needed to optimize EFS strategies for enhanced growth in this vulnerable population.
Abstract:
We sought to outline trends in anthropometric growth before and after cardiac transplantation and to document our experience with the use of EFS in this population. A total of 130 patients (59% male) were enrolled and followed for a median of 4.4 yr after transplantation. Negative changes over time in weight z-score (EST: -0.256 [0.160] z/yr, p = 0.01), height z-score (EST: -0.214 [0.096] z/yr, p = 0.03), and BMI z-score (EST: -0.287 [0.161] z/yr, p = 0.07) were observed prior to transplantation. Significant increases in weight z-score (EST: +0.342 [0.143] z/yr, p < 0.001) and BMI z-score (EST: +0.396 [0.140] z/yr, p = 0.005) were seen in the first 18 months following transplantation. No further increases in height, weight, or BMI z-score were seen beyond this. Forty-two (32%) patients received EFS. Prior to transplantation, it was not found to be associated with change in anthropomorphic growth. Post-transplantation exposure to EFS was associated with a faster increase in weight z-score (EST: +0.480 [0.231] z/yr, p = 0.04) and height z-score over time (EST: +0.366 [0.141] z/yr, p = 0.01). Normalization of weight and height z-scores was not achieved during the study follow-up period. This study suggests that further investigation into the role of EFS is warranted to identify strategies to improve growth in pediatric heart transplant recipients.
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