Skip to main content
SpringerLink
Log in

Exercise Performance in Pediatric Liver Transplant Recipients and Its Related Cardiac Function

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate an exercise test in pediatric liver transplant recipients and its relation to their cardiac function. This cross-sectional study was conducted on 58 children who had successfully undergone orthotopic liver transplantation at least 6 months prior to the study, with the same age and gender-matched control group. M-mode, Doppler, tissue Doppler echocardiography and an exercise test were performed for all the participants. The VO2 values and METS in patients were less than the control (P = 0.001). Left ventricular posterior wall thickness in systole, left ventricular posterior wall thickness in diastole, interventricular septum diameter in diastole, AT, pulmonary acceleration time, ST and EaT, AaM, and SS had a significant difference between patients and the control group (P value < 0.05). Maximal oxygen consumption (Max VO2) and metabolic equivalent task (METs) values had a significant correlation with tricuspid valve S parameter (P = 0.018, r = 0.310). Max VO2 and METs values did not have a significant correlation with the diastolic dysfunction index, such as E/A and E/Ea. In this study, the exercise test showed decreased functional capacity in liver-transplanted children; however, the echocardiographic evaluation did not reveal any definite correlation with systolic or diastolic dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McDiarmid SV (2001) Management of the pediatric liver transplant patient. Liver Transpl 7(1):S77–S86

    Article  CAS  PubMed  Google Scholar 

  2. Englesbe MJ, Kelly B, Goss J, Fecteau A, Mitchell J, Andrews W et al (2012) Reducing pediatric liver transplant complications: a potential roadmap for transplant quality improvement initiatives within North America. Am J Transpl 12(9):2301–2306

    Article  CAS  Google Scholar 

  3. Neviere R, Edme JL, Montaigne D, Boleslawski E, Pruvot FR, Dharancy S (2014) Prognostic implications of preoperative aerobic capacity and exercise oscillatory ventilation after liver transplantation. Am J Transpl 14(1):88–95

    Article  CAS  Google Scholar 

  4. Zaky A, Bendjelid K (2015) Appraising cardiac dysfunction in liver transplantation: an ongoing challenge. Liver Int 35(1):12–29

    Article  PubMed  Google Scholar 

  5. Khemakanok K, Khositseth A, Treepongkaruna S, Teeraratkul S, Pansrimangkorn W, Leelaudomlipi S et al (2015) Cardiac abnormalities in cirrhotic children: pre- and post-liver transplantation. Hepatol Int 10(3):518–524

    Article  PubMed  Google Scholar 

  6. Graham RM (1994) Cyclosporine: mechanisms of action and toxicity. Cleve Clin J Med. 61(4):308–313

    Article  CAS  PubMed  Google Scholar 

  7. Ventura HO, Malik FS, Mehra MR, Stapleton DD, Smart FW (1997) Mechanisms of hypertension in cardiac transplantation and the role of cyclosporine. Curr Opin Cardiol 12(4):375–381

    CAS  PubMed  Google Scholar 

  8. Jain A, Mazariegos G, Kashyap R, Green M, Gronsky C, Starzl TE, and et al (2000) Comparative long-term evaluation of tacrolimus and cyclosporine in pediatric liver transplantation. Transplantation 70(4):617–625

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Mandell MS, Lindenfeld J, Tsou MY, Zimmerman M (2008) Cardiac evaluation of liver transplant candidates. World J Gastroenterol 14(22):3445–3451

    Article  PubMed  PubMed Central  Google Scholar 

  10. Raval Z, Harinstein ME, Skaro AI, Erdogan A, DeWolf AM, Shah SJ et al (2011) Cardiovascular risk assessment of the liver transplant candidate. J Am Coll Cardiol 58(3):223–231

    Article  PubMed  Google Scholar 

  11. Maria da Silva R, Brunow de Carvalho W, Johnston C, Borba de Castro M, Manta Ferreira I, Patti CL et al (2014) Functional capacity after pediatric liver transplantation: a pilot study. Pediatr Transpl 18(6):586–593

    Article  Google Scholar 

  12. Derakhshan A, Derakhshan D, Amoozgar H, Shakiba MA, Basiratnia M, Fallahzadeh MH (2014) Exercise test in pediatric renal transplant recipients and its relationship with their cardiac function. Pediatr Transpl 18(3):246–253

    Article  Google Scholar 

  13. Abd-El-Aziz TA, Abdou M, Fathy A, Wafaie M (2010) Evaluation of cardiac function in patients with liver cirrhosis. Intern Med 49(23):2547–2552

    Article  PubMed  Google Scholar 

  14. Chen Y, Chan AC, Chan SC, Chok SH, Sharr W, Fung J et al (2016) A detailed evaluation of cardiac function in cirrhotic patients and its alteration with or without liver transplantation. J Cardiol 67(2):140–146

    Article  PubMed  Google Scholar 

  15. Shalev A, Nir A, Granot E (2005) Cardiac function in children post-orthotopic liver transplantation: echocardiographic parameters and biochemical markers of subclinical cardiovascular damage. Pediatr Transpl 9(6):718–722

    Article  CAS  Google Scholar 

  16. Vandekerckhove K, Coomans I, De Bruyne E, De Groote K, Panzer J, De Wolf D, Boone J, De Bruyne R (2016) Evaluation of exercise performance, cardiac function, and quality of life in children after liver transplantation. Transplantation 100(7):1525–1531

    Article  PubMed  Google Scholar 

  17. Rongies W, Stepniewska S, Lewandowska M, Smolis-Bak E, Dolecki W, Sierdzinski J, Trzepla E, Cholewinska G, Stankiewicz W (2011) Physical activity long-term after liver transplantation yields better quality of life. Ann Transplant 16(3):126–131

    Article  PubMed  Google Scholar 

  18. Beyer N, Aadahl M, Strange B, Kirkegaard P, Hansen BA, Mohr T, Kjaer M (1999) Improved physical performance after orthotopic liver transplantation. Liver Transpl Surg 5(4):301–309

    Article  CAS  PubMed  Google Scholar 

  19. Lemyze M, Dharancy S, Nevière R, Pruvot FR, Declerck N, Wallaert B (2010) Aerobic capacity in patients with chronic liver disease: very modest effect of liver transplantation. Presse Med 39(7–8):e174–e181

    Article  PubMed  Google Scholar 

  20. Kotarska K, Wunsch E, Jodko L, Raszeja-Wyszomirska J, Bania I, Lawniczak M et al (2016) Factors affecting exercise test performance in patients after liver transplantation. Hepat Mon 16(3):e34356

    Article  PubMed  PubMed Central  Google Scholar 

  21. Zaky A, Lang JD (2014) Cardiac Dysfunction in liver transplantation. Austin J Anesth Analg 2(1):1007

    Google Scholar 

Download references

Acknowledgements

The authors thank the transplant and cardiac research center at Shiraz University of Medical Sciences, Shiraz, Iran. The authors would also like to thank Mr. H. Argasi at the Research Consultation Center (RCC) at Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript. Finally, we would like to thank Dr. Varahram and Ms. Marzban in the Emam Reza exercise test unit for their cooperation in performing exercise tests. We acknowledge the Vice Chancellor of Research at Shiraz University of Medical Sciences for their financial support with the Grant Number 6944.

Author information

Authors and Affiliations

  1. Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Seyed Mohsen Dehghani, Seyed Ali Malek Hoseini & Saman Nikeghbalian

  2. Pediatric Department, Shiraz University of Medical Sciences, Shiraz, Iran

    Mitra Moshref

  3. Neonatal Research Center and Cardiovascular Research Center, Pediatric Office Nemazee Hospital, Shiraz University of Medical Sciences, 7193711351, Shiraz, Iran

    Hamid Amoozgar

Authors
  1. Seyed Mohsen Dehghani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mitra Moshref
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hamid Amoozgar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seyed Ali Malek Hoseini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Saman Nikeghbalian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hamid Amoozgar.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical Approval

All procedures involving human participants were in accordance with the ethical standards of Shiraz University of Medical Sciences research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Written informed consents were obtained from the patients and/or their parents/guardian prior to their enrolment in this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dehghani, S.M., Moshref, M., Amoozgar, H. et al. Exercise Performance in Pediatric Liver Transplant Recipients and Its Related Cardiac Function. Pediatr Cardiol 39, 548–554 (2018). https://doi.org/10.1007/s00246-017-1786-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-017-1786-3

Keywords

Search

Navigation