Changes in serum cholesterol, lipoproteins and triglycerides after cardiac, transplantation in children

Total cholesterol, HDL and LDL-cholesterol and triglyceride levels may cont ribute to the development or progression of coronary artery disease of the transplanted heart. The aim of this retrospective study was to determine th e short and longterm lipid profiles of transplanted children and to identif y factors influencing these dyslipidemias. Twenty-three patients aged 9.5 +/- 5.9 years at cardiac transplantation wer e followed up for 5.8 +/- 3.1 years. All were on triple therapy with normal diets. The total cholesterol increased by 17% during the first year (4.47 +/- 1.01 mMol/l to 5.25 +/- 1.22 mMol/l at 1 year; p < 0.05) with a peak at 3 month s of 5.31 +/- 1.28 mMol/l correlating with the dosage of prescribed cortico steroids. LDL-cholesterol levels increased by 20% during the first year (2. 26 +/- 0.67 mMol/l to 3.29 +/- 0.99 mMol/l at 1 year; p = 0.018). HDL-chole sterol levels increased from 1.02 +/- 0.27 mMol/l to a maximum of 1.55 +/- 0.4 mMol/l at 1 year, p < 0.05, Lipoprotein Al, a protecting sub-fraction o f HDL, did not change significantly. Changes in triglyceride levels were no t significant despite a tendency to hypertriglyceridaemia in the early phas es. After one year, serum cholesterol and lipoprotein levels remained highe r than the initial values. These results show that cardiac transplant children are exposed to the risk of atherogenic hyperlipidaemia and require systematic lipid profile monito ring, dietary advice and lipid lowering drugs.