Abstract
<h3>Purpose</h3> Nutritional status in pediatric patients undergoing heart transplantation (HT) is frequently a focus of clinical management and requires high resource utilization. However, no studies have been performed to assess how nutritional status may change after HT and the risk of developing nutritional comorbidities (i.e. metabolic syndrome). <h3>Methods</h3> A single-center retrospective chart review of patients > 2 years of age who underwent HT from 1/1/2005 to 4/30/2020 was performed. Patient data was collected at listing, time of transplant, 1-year, and 3-year follow up (f/u). Nutrition status was classified based on body mass index (BMI) percentile (Table below). Standard univariate analyses were used to examine associations between nutrition status and post-HT morbidity or mortality, including metabolic syndrome. <h3>Results</h3> Of 63 patients who underwent HT, the proportion of patients with overweight/obese status increased from 21% at listing to 41% at 3-year f/u. No underweight patients at listing became overweight/obese at f/u, but 38% of normal weight patients crossed into overweight/obese at 3-year f/u, while 88% of overweight/obese patients maintained that status (Table). Overweight/obese status at listing, 1-year and 3-year post-HT were significantly associated with developing metabolic syndrome post-HT (p≤0.01 for each). Finally, there was no association between nutrition status at listing and immediate post-HT morbidity or mortality with the exception of underweight at listing being a risk for ECMO post-HT (p=0.03). <h3>Conclusion</h3> Patients with normal and overweight/obese status prior to HT are at significant risk to be overweight/obese after HT. Post-HT overweight/obesity is associated with an increased risk of developing metabolic syndrome. These findings underscore the importance of formal post-HT nutritional surveillance and interventions to reduce nutritional comorbidities.
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