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Updated: Feb 8, 2026
Orthotopic Liver Transplantation in Rats
Published on: July 1, 2012
De novo aortopathy and cardiovascular outcomes in paediatric liver transplant recipients
James G Huang1, Terence Lim1, Swee-Chye Quek1
11Department of Paediatrics,Yong Loo Lin School of Medicine,National University of Singapore,Singapore,Singapore.
Insights
Pediatric liver transplant recipients can develop new-onset aortopathy, a cardiovascular abnormality. Glycogen storage disease type I is a significant risk factor for this condition post-transplant.
Area of Science:
- Pediatric Cardiology
- Transplant Surgery
- Hepatology
Background:
- Long-term survival in pediatric liver transplant recipients has increased, shifting focus to post-transplant care.
- De novo cardiovascular abnormalities can arise in asymptomatic children after liver transplantation.
- Routine monitoring is crucial for detecting these emergent conditions.
Purpose of the Study:
- To describe de novo cardiovascular abnormalities in pediatric liver transplant recipients.
- To identify risk factors associated with the development of aortopathy after liver transplantation.
- To understand the long-term implications of liver transplantation on cardiovascular health.
Main Methods:
- Retrospective analysis of 96 pediatric liver transplants performed between 1991 and 2014.
- Identification of new-onset aortopathy in asymptomatic recipients during routine post-transplant monitoring.
- Univariate and multivariate analyses to determine risk factors for aortopathy.
Main Results:
- 7.8% (7/90) of pediatric liver transplant recipients developed new-onset aortopathy.
- Glycogen storage disease type I (GSD I) and Epstein-Barr virus (EBV) seropositivity were significant risk factors on univariate analysis.
- GSD I remained the only significant risk factor for aortopathy on multivariate analysis (OR 51.3, p=0.047).
Conclusions:
- Liver transplantation can reverse some cardiopulmonary complications but may also induce de novo aortic dilation.
- Glycogen storage disease type I is a critical risk factor for developing aortopathy in pediatric liver transplant recipients.
- Ongoing surveillance for cardiovascular complications is essential in the long-term management of these patients.
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.
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