Lipid Profiles in Pediatric Thoracic Transplant Recipients are Determined by Their Immunosuppressive Regimens

Adverse Effects of Immunosuppression in Pediatric Solid Organ Transplantation

“…[75] Dyslipidemia in children is characterized by an increase in total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels. [61,75,76] Long-term immunosuppression is the primary risk factor for the development of dyslipidemia. As with hypertension, ciclosporin-based regimens are associated with a higher risk of dyslipidemia than tacrolimus-based regimens.…”

“…As with hypertension, ciclosporin-based regimens are associated with a higher risk of dyslipidemia than tacrolimus-based regimens. [67,76,77] Ciclosporin levels have been shown to correlate with lipid profiles. [78] Corticosteroids also contribute to dyslipidemia; this can be synergistic with the effects of ciclosporin and tacrolimus.…”

“…[70] One study showed beneficial effects on lipid profiles in children who were switched from ciclosporin to tacrolimus. [76] The use of HMG-CoA reductase inhibitors (statins), particularly pravastatin and atorvastatin, has been shown to be safe and effective in pediatric kidney and heart transplant recipients. [80][81][82] …”

Cure of multifocal panhepatic hepatoblastoma: is liver transplantation always necessary?

“…On the other hand, although the results of pediatric LT have regularly improved and nowadays reach 95% 3-year patient survival [40], growing concern appears regarding the long-term outcome of these patients: in the current state of knowledge, lifelong immunosuppression is needed for most children, and a wide range of potential long-term complications are possible, including impairment of renal function [41][42][43]; dyslipidemia [44][45][46][47]; lymphoproliferative disorders; and other de novo tumors [48][49][50][51], infections [52][53][54], and chronic and late acute rejection [10,55]. In the current recommended treatment of multinodular panhepatic HBs by total hepatectomy and LT, these possible long-term sequelae are the counterpart for the increased rate of patients whose disease can be cured.…”

Treatment of dyslipidaemia in childhood

“…Dyslipidaemia (i.e., increased total cholesterol and LDL-C levels), is a common complication after all types of solid organ transplantation, contributing to an increased cardiovascular risk and chronic rejection [118,119]. The use of calcineurin inhibitors and corticosteroids is the most likely explanation for lipoprotein abnormalities [120]. Especially in paediatric heart transplantation, with coronary artery disease as the most important cause of post-transplantation mortality, it is recommended that statin therapy be started immediately after transplantation [103].…”