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G40(P) Tacrolimus associated symptomatic cardiac hypertrophy and pulmonary hypertension is reversible in children recipients of orthotopic living related liver transplantation

Kotb, MA ; Satar, E Abd El ; Badr, AM ; Anis, NH ; Hamza, AF

Archives of disease in childhood, 2016-04, Vol.101 (Suppl 1), p.A26-A26 [Periódico revisado por pares]

London: BMJ Publishing Group LTD

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  • Título:
    G40(P) Tacrolimus associated symptomatic cardiac hypertrophy and pulmonary hypertension is reversible in children recipients of orthotopic living related liver transplantation
  • Autor: Kotb, MA ; Satar, E Abd El ; Badr, AM ; Anis, NH ; Hamza, AF
  • É parte de: Archives of disease in childhood, 2016-04, Vol.101 (Suppl 1), p.A26-A26
  • Descrição: BackgroundSurgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immunosuppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias.Aimof work To assess cardiovascular structural and functional changes in children recipients of OLRLT.MethodsWe assessed cardiac structure and function in 25 children recipients of orthotopic living related liver transplantation by conventional 2-D, M- mode echocardiography and Doppler.ResultsMean age +/- SD at transplantation and at enrollment in study were 6.3+/ 4.5yrs and 13.5 +/- 5.6 yrs respectively. All children were on tacrolimus, as a single immunosuppressive medicine in only 3, and in association with steroids, azathioprine or mycofenolate mofitel as a double therapy (12 children), triple therapy (10 children). Echocardiography showed significant interventricular septal hypertrophy (mean thickness 0.89) in 21, 24 had pulmonary hypertension (mean mPAP +/-36.4), and early diastolic dysfunction Tei index (mean +/- 0.40). However Cardiac function was generally preserved. A child developed severe aortic stenosis that necessitated catheter dilatation and was reversed over 12 months after discontinuation of tacrolimus. Discontinuation of tacrolimus reversed pulmonary hypertension, diastolic dysfunction and hypertrophy of left ventricle and/or interventricular hypertrophy.ConclusionAsymptomatic cardiac adverse effects are common following OLRLT. We encountered pulmonary hypertension, increased cardiac mass, aortic stenosis and diastolic heart failure among our studied population. Findings are reversed within 12 months of discontinuation of tacrolimus.
  • Editor: London: BMJ Publishing Group LTD
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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