A Study of Pediatric Heart Transplant Patients in Relationship to Post Transplant Coronary Artery Disease

<p>Post transplant coronary artery disease influences short and long-term survival of pediatric heart transplant recipients. Associated cardiovascular disease risk factors among non-heart transplant adult and pediatric heart populations for development of coronary artery disease have been documented. Little is known about these typical cardiovascular disease risk factors as well as other possible risk factors in the development of post transplant coronary artery disease. <strong>Objective:</strong> The purpose of this research was to examine children/adolescents (n=194), 5-18 years old, at least one-year post heart transplant. This study also investigated if there were physiological and psychological/behavioral differences between recipients with (n = 28) and without post transplant coronary artery disease (n = 166). <strong>Method: </strong>Archival (physiological) data were collected from the Loma Linda Heart Institute computer database, and behavioral prospective data were obtained from a mailed survey of parents (n = 173) (Child Behavior Checklist and Demographic Information Form). <strong>Results</strong>: Total number of rejection episodes (4.88 vs 2.88) and mean triglyceride levels (115.50 vs 85.90) were higher for recipients with post transplant coronary artery disease. Parents reported psychological variables of anxiety/depression (50.67 vs 54.58), aggression (51.33 vs 54.26), and thought problems (50.00 vs 55.32) were higher for recipients without post transplant coronary artery disease. Recipients whose parents smoked in the past or currently smoke had a greater total number of rejection episodes (4.82 vs 2.58) than recipients with parents who did not smoke in the past or currently.</p> <p><strong>Conclusions:</strong> The results indicate that rejection episodes, triglyceride levels, and parental smoking behavior generate a greater risk for developing post transplant coronary artery disease. Addressing the implications of these results for pediatric heart transplant recipients, parents, and transplant programs should be accomplished by professionals who hold the skill and experience in the fields of preventive care and mental health. Focal point to lifestyle wellness dynamics such as nutrition, smoking cessation, and successful long term behavior change in conjunction with transplant medical care will offer recipients the best chance for a long and improved quality of life.</p>

Name thesis:degree_name

Doctor of Public Health (DrPH)

Level thesis:degree_level

Dissertation

Year

2004

Author dc:creator

• Randall, Mark

Contributors dc:contributor

• Helen Hopp Marshak
• Kiti Freier
• Gray Hopkins

• Cardiology
• Preventive Medicine
• Public Health Education and Promotion
• Heart Transplantation -- in infancy & childhood; Adolescent; Child; Coronary Disease; Coronary Arteriosclerosis; Transplantation -- complications.

Statement dc:rights

• This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Language dc:language

English

Repository record dc:identifier

https://scholarsrepository.llu.edu/etd/1342

OAI identifier oai:identifier

oai:scholarsrepository.llu.edu:etd-2114