(1138) - Nutritional Status of Children Undergoing Heart Transplantation at the Heart Institute of São Paulo (Incor) between 2013-2015

Abstract

Congestive heart failure in children presents as an increased risk for malnutrition, due to cardiac cachexia and increased metabolic demand. The effect of malnutrition on adults undergoing heart transplantation (HTx) has been well-studied; however there are few data on pediatric population. The goal of our study was to analyse the nutritional status of children undergoing HTx at the Heart Institute of Sao Paulo (Incor), Brazil. We conducted a retrospective analysis of the medical records of all pediatric patients who underwent HTx between 2013 and 2015. Fifty-five patients were submitted to heart transplantation (28 girls and 27 boys), with an average age of 10 years. The average height was 127 cm ( median 131 cm, standard deviation (stdev) 32 cm), and the average Z-score according to world health organization (WHO) growth charts was -1,12 (median -0,97; stdev 2,01). The average body mass index Z-score according to world health organization (WHO) growth charts was -1,75 (median -0,8; stdev 1,7). We used the WHO definition for thinness, which is BMI Zscore<-2. There were 15 patients (27%) with diagnosis of thinness, of whom 7 had severe thinness (BMI Zscore<-3). There were no obese patients. Wasting was present in 18% of patients with congenital heart disease and 35% of patients with cardiomyopathy. There were 6 boys whose BMI Zscore was below -2, and 9 girls were under the same condition. Among the patients who died after heart transplantation, 31% were thin or severely thin before the procedure, while among those who survived heart transplantation, 28% were thin or severely thin. The data shows a tendency towards malnutrition at the time of HTx, which may impact on the outcome of the procedure.