Since May 1990, in the Italian Hospital 30 transplantation procedures (TX)[28 orthotopic heart transplantations (HTX) & 2 lungs and heart transplantations (HLTX)] have been performed in 28 children with a 65% overall survival at 6 years. Anthropometric parameters & the IGF-I-IGFBP3 axis were evaluated in 29 patients (19 females), 16 in a waiting list for HTX(n=6) or HLTX (n=10), ages ranging from 1.9 to 20.7 years (median 7.4) (10 Tanner I) & 13 transplanted patients, HTX (n=11), LHTX (n=2), ages ranging from 2.4 to 16.6 years (median 11) (B Tanner I), treated with immunosuppressive doses of cyclosporine, azathioprine & aethylprednisone. Pre & post TX sean weight/height ratio (W/H) was -9.1±10.7 vs-5.9±8.8% (p=NS), body mass index (BMI) 15.9±2.5 vs 16.4±2.4 kg/s2 (p=NS), SDS of height -0.84±1.1 vs-0.51±0.9DS (p=NS). The SDS of height was significantly below normal in the preTX group only (p<0.05,Wilcoxon test). We found:Table: [Illegible Text] p<0.001 pre vs post TX(Mann-Whitney test); [Illegible Text] p<0.05 vs normal (Wilcoxon test). There was correlation between: IGF-1 & IGFBP3 preTX r=0.80, posTX r=0.80; years post TX & IGFBP3 r=0.74; IGFBP3 & both W/H & BMI r=0.55 y 0.53 only in the preTX group (Spearman rank correlation). Conclusions: Patients in the preTX group presented low mean height SDS with normal mean values of IGFBP3, IGF-I & IGF-I/IGFBP3 molar ratio. PosTX we found an improvement in height & an increase of 0.9 SD in IGF-I mean value and of 1.85 SD in IGFBP3 mean value with preservation of molar ratio. The significantly elevated IGFBP3 mean level (compared to normal and preTX values) could be related to favorable changes in the somatotrophic axis and/or to the concomitant immunosuppressive therapy.

Table 1
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