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Incidence of cardiovascular disease and mortality in childhood solid organ transplant recipients: a population-based

Sandeep Brar1,2, Stephanie N Dixon3,4,5, J Michael Paterson6,7

  • 1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.

Pediatric Nephrology (Berlin, Germany)
|July 18, 2022
PubMed

Insights

Children who undergo solid organ transplantation face a significantly higher risk of cardiovascular events. Long-term monitoring is crucial for these pediatric patients to manage cardiovascular health after transplant.

Area of Science:

  • Pediatric Cardiology
  • Transplant Medicine
  • Public Health

Background:

  • Improved survival rates in pediatric solid organ transplantation necessitate understanding long-term comorbidity risks.
  • Long-term cardiovascular event and mortality risks post-pediatric solid organ transplantation remain understudied.

Purpose of the Study:

  • To compare the incidence of cardiovascular events in pediatric solid organ transplant recipients versus a control group of children with asthma.
  • To assess long-term cardiovascular outcomes, including non-fatal events, cardiovascular death, and all-cause mortality, following pediatric solid organ transplantation.

Main Methods:

  • A cohort study utilized health administrative data from 1996-2014.
  • Compared 615 pediatric solid organ transplant recipients (liver, lung, kidney, small bowel, multi-organ) with 481,697 children with asthma.
  • Employed time-stratified Cox proportional hazards models to analyze outcomes.

Main Results:

  • Pediatric solid organ transplant recipients experienced a 34-fold higher rate of non-fatal cardiovascular events compared to non-transplanted children.
  • Cumulative incidence of non-fatal cardiovascular events was 2.3% at 5 years and 13.0% at 15 years post-transplantation.
  • The study included kidney (52%), liver (41%), and other solid organ transplants, with a median follow-up of 12.1 years.

Conclusions:

  • The significantly increased rate of cardiovascular events in pediatric solid organ transplant recipients underscores the need for lifelong surveillance.
  • Effective management strategies and transition care are vital for addressing long-term cardiovascular risks in this population.
  • Further research into specific risk factors and interventions is warranted to improve long-term outcomes.
Abstract

Keywords:
Cardiovascular diseaseChildrenHealth administrative databasesMortalitySolid organ transplant

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