Factors influencing the development of hypercholesterolemia after cardiac transplantation

Kubo, Spencer H.; Peters, Jeffrey R.; Knutson, Kevin R.; Hertz, Marshall I.; Olivari, Maria Teresa; Bolman, R. M.; Hunninghake, Donald B.

doi:10.1016/0002-9149(92)91201-e

Cited by 24 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LDL‐C levels higher than 100 mg/dL (the desired level for these patients) are found in approximately 80% of patients 1 yr after intervention. This increase is evident approximately 2 wk after transplantation, reaching a peak between the first 3 and 6 months and in some cases dropping between the second and third years (3, 5–13), similar to the results that we observed in our study population. With regards the TG levels, results are also diverse (4, 5, 13).…”

Section: Discussionsupporting

confidence: 91%

“…The etiology of this hyperlipidemia is unknown and multifactorial (3–5), and is most prevalent in older patients (5, 7), in those with coronary artery disease before the intervention (5, 7, 9, 13) and over‐weight subjects (4). Several studies have suggested a causal relationship between cyclosporin treatment and hyperlipidemia in animals (14–17), heart transplant (18–22) and bone marrow recipients (23), because of inhibition of lipoprotein lipase activity (LPL) (16) and a decrease in LDL plasma clearance secondary to hepatic dysfunction produced by cyclosporin (17).…”

Section: Discussionmentioning

confidence: 99%

“…Hyperlipidemia is a key element in the development of post‐transplant coronary atherosclerosis. Its etiology is not well known and it may be multifactorial (3–5), influenced by genetic and environmental factors (especially immunosuppression therapy) (13–17).…”

mentioning

confidence: 99%

See 2 more Smart Citations

The apo A‐I gene promoter region polymorphism determines the severity of hyperlipidemia after heart transplantation

González-Amieva¹,

Marı́n²,

Pérez-Martínez³

et al. 2003

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The apo A‐I gene promoter region polymorphism determines the severity of hyperlipidemia after heart transplantation

González-Amieva¹,

Marı́n²,

Pérez-Martínez³

et al. 2003

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…18 -20 The reported benefits to these steroid-free regimens include a decreased requirement for antihypertensive agents, 21 and decreased incidence of cataract formation and diabetes mellitus. 22 Likewise, these centers report improvement in bone density with fewer compression fractures, 18 as well as improvement in lipid profiles, 23 all without significantly increasing the risk of rejection or mortality. The programs that propose the continued use of steroids as part of their posttransplantation regimen point to prospective data that suggests stopping steroids place patients at increased risk of acute rejection without significant benefits.…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis Intestinalis After Pediatric Thoracic Organ Transplantation

et al. 2002

View full text Add to dashboard Cite

ABSTRACT. Objective. To review and describe pneumatosis intestinalis (PI) in children who have undergone thoracic organ transplantation and evaluate potential risk factors.Methods. We retrospectively reviewed abdominal radiographs obtained from June 1992 through September 2000 in all pediatric (age <21 years) thoracic organ recipients who survived at least 1 week after transplantation. In this group, a case was defined as an episode of radiographically confirmed PI; those without PI were assigned as controls. Variables analyzed included demographic data, gastroenteritis history (stool cultures or symptoms of gastroenteritis), and transplant-related factors (ie, graft type, rejection history, immunosuppression regimen). Significance was defined as P < .05.Results. Over this 8-year period, PI occurred in 8 (7%) of 116 patients (0.86% annual risk). No child had >1 diagnosed episode of PI. Of these 8 cases, 7 presented with 1 or more abdominal symptoms. Three of these children had rotavirus antigen isolated in their stool, 2 others were noted to have stool positive for Clostridium difficile toxin, and in the other 3, no pathogen was identified. All cases were treated with a regimen of intravenous antibiotics and total parenteral nutrition. There were no deaths; however, 1 patient developed an Aspergillus pulmonary infection during his course of antibiotic therapy, and another underwent an exploratory laparotomy without bowel resection. Significant risk factors included black race (unadjusted odds ratio: 16), younger age at presentation (age <5 years; unadjusted odds ratio: 9), higher steroid dose (steroid dose >0.5 mg/kg/d; unadjusted odds ratio: 7), and a higher tacrolimus level at presentation (tacrolimus level >1; unadjusted odds ratio: 6). PI did not occur with a steroid dose <0.4 mg/kg/d. Variables not associated with increased risk for developing PI included gender, graft type, total white blood cell count, recent antibiotic use, concurrent use of an antimetabolite, cytomegaloviral infection, past use of extracorporeal membrane oxygenation, and graft rejection history.Conclusions. Significant risk factors for the development of PI in our pediatric thoracic organ transplantation population included black race, younger age, higher daily steroid dosing, and a high tacrolimus level at presentation. In the children diagnosed with PI, there were no related deaths, significant gastrointestinal sequelae, or complications. These findings suggest that in this population, PI will often have a benign course when treated aggressively, and that steroid dosing should be reduced to <0.5 mg/kg/d whenever possible. Pediatrics 2002;109(5). URL: http://www.pediatrics.org/cgi/content/ full/109/5/e78; pediatric heart transplantation, pediatric lung transplantation, pediatric heart-lung transplantation, pneumatosis intestinalis, steroids.

show abstract

“…[12][13][14][15] Furthermore, some researchers have suggested that post-transplant obesity may contribute to hyperlipidemia and cardiac allograft vasculopathy. 9,10,16,17 In addition, pretransplant cachexia has been identified as a risk factor for poor survival after heart transplantation. 11,13 However, the relationship between post-heart transplant change in body weight (cachexia and obesity) and subsequent morbidity and mortality has not yet been reported.…”

mentioning

confidence: 99%

Post-Operative Obesity and Cachexia Are Risk Factors for Morbidity and Mortality After Heart Transplant: Multi-Institutional Study of Post-Operative Weight Change

Grady

Naftel

Pamboukian

et al. 2005

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

Factors influencing the development of hypercholesterolemia after cardiac transplantation

Cited by 24 publications

References 7 publications

The apo A‐I gene promoter region polymorphism determines the severity of hyperlipidemia after heart transplantation

The apo A‐I gene promoter region polymorphism determines the severity of hyperlipidemia after heart transplantation

Pneumatosis Intestinalis After Pediatric Thoracic Organ Transplantation

Post-Operative Obesity and Cachexia Are Risk Factors for Morbidity and Mortality After Heart Transplant: Multi-Institutional Study of Post-Operative Weight Change

Contact Info

Product

Resources

About