The profile of inflammatory and metabolic response in children undergoing heart transplantation

Authors


  • Conflict of interest: The authors have no conflict of interest to declare.

Corresponding author: Jia Li, MD, PhD, Division of Pediatric Cardiology, Stollery Children’s Hospital, Department of Pediatrics, University of Alberta, Mazankowski Alberta Heart Institute, 8215-112th Street, Edmonton, AB, Canada T6G 2C8.
Tel.: +1 780 492 8463; fax: +1 780 492 6556; e-mail: Jia.Li@albertahealthservices.ca

Abstract

Yu X, Larsen B, Urschel S, Cheung P-Y, Ross DB, Rebeyka I, West L, Li J. The profile of inflammatory and metabolic response in children undergoing heart transplantation.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01566.x.
© 2011 John Wiley & Sons A/S.

Abstract:  Inflammatory and metabolic response is an important factor to determine clinical outcomes. However, it remains unknown in children undergoing heart transplantation (HTx). We examined the perioperative changes in the inflammatory and metabolic response markers C-reactive protein (CRP) and prealbumin (PA) in 38 heart-transplanted children. Data obtained prior to and within one month after HTx included CRP, PA, total and differential white blood cell counts, doses of inotropes and immunosuppressants, cultures of blood and body fluids, duration of cardiopulmonary bypass (CPB), aortic cross clamp and donor heart ischemia, and days in the intensive care unit (ICU) and hospital. CRP was 32 ± 49 mg/L before HTx, increased to 130 ± 55 mg/L on postoperative day 1–2, and decreased to 21 ± 31 mg/L by one month after HTx. PA was 0.15 ± 0.06 g/L before HTx, decreased to 0.12 ± 0.03 g/L on postoperative day 1–2, and then gradually increased to 0.21 ± 0.10 g/L by one month after HTx. Postoperative CRP positively correlated with epinephrine dosage and CPB duration. PA positively correlated with age. In conclusion, inflammatory and metabolic response is present before HTx and acutely intensified after HTx. It may be mainly influenced by CPB duration and cardiovascular function status.

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