LIPID AND CARBOHYDRATE METABOLISM, AND ANTIOXIDANT STATUS IN CHILDREN AFTER LIVER TRANSPLANTATION

Abstract

Organ transplantation is a risk factor of atherogenesis that may be related to immune suppression therapy. Increased free radical generation may even aggrevate atherogenesis. The aim of the study was to assess lipid metabolism in relation to risk factors of atherogenesis as well as carbohydrate metabolism and antioxidant status in children after liver transplantation. Material: We investigated 35 children 3-5 y after liver transplantation aged 10.6 ± 4.7. We did not observe major liver injury in the patients studied (normal bilirubin and INR). Results: 95% conf. interval of total cholesterol (150-191 mg/dl), LDL-C (83-111 mg/dl), VLDL-C (12-18 mg/dl), HDL-C (44-54 mg/dl), apo AI (1.27-1.49 g/l), apo B (0.6-0.89 g/l), alpha-tocopherol (7.8-8.83 μg/ml) serum concentrations were within the normal limits. GSH was decreased in transplanted children when compared to 28 aged matched healthy controls (527.6-606.6 μmol/ml vs. 667.5-763.5), whereas GPx activity was similar in the study and control group (28.3-32.8 U/gHb vs. 30.6-34.5). Kruskall Wallis analysis in subgroups of children treated with cyclosporine (Cs) only (n = 8), tacrolimus (Tac) only (n = 12) and mycophenolate mofetil (MMF; n = 8) showed differences only in total cholesterol (Cs: 131.6-285.6; Tac: 144.0-181.6l; MMF: 132.1-181.2) and LDL-C (Cs: 79.4-126.9; Tac: 42.2-118.8; MMF: 74.2-117.3). Conclusion: Lipid metabolism is not significantly disturbed in children after liver transplantation that does not point to the high risk of atherogenesis. Cyclosporine seems to have the strongest untoward effect on cholesterol metabolism. GSH concentration is decreased after liver transplantation that may be related to slightly impaired liver function, but GPx activity and alpha-tocopherol concentration remain normal.