Effect of age on lipid profiles in pediatric heart transplant recipients

This study's objectives were to determine if pediatric ortho- topic heart transplant (OHT) recipients over all ages develop hyper- lipidemia and, secondarily, to identify the effects of immunosuppressive agents and statins on lipid profiles in these patients. Retrospective chart review was performed for pediatric patients transplanted between January 1987 and June 2002. Of the 100 OHTs performed, 50 patients satisfied the inclusion criteria and were grouped by age at OHT as follows: group 1 (n ¼ 16): 0-4 yr; group 2 (n ¼ 10): 5-9 yr; group 3 (n ¼ 15): 10-14 yr; group 4 (n ¼ 9): 15-18 yr. There were 2789 lipid levels recorded, and each patient had an average of 14 post- OHT lipoprotein panels measured. Post-OHT total cholesterol and low-density lipoprotein (LDL) levels were significantly greater than those of the general population for the entire follow-up period in all age groups, except for LDL levels in group 2. Cyclosporin level and pred- nisone dose were positively associated with total cholesterol and LDL levels (p < 0.03). Statins significantly decreased total cholesterol and LDL levels (p < 0.001). Hyperlipidemia affects OHT patients of all ages. Even the youngest patients may benefit from immunosuppression using an alternative to cyclosporin, such as tacrolimus, and steroid-free regimens, which may improve lipid profiles. Once safety and efficacy data are available, all age groups may benefit from statins.