Table 1.

Summary of studies on MS in pediatric transplant recipients

Author	Year	MS definition	Prevalence	Results/associations
Ramirez-Cortez et al. [11]	2009	≥3 criteria: WC > 75 cm BP > 95th percentile HDL-C ≤ 10th percentile TG ≥ 90th percentile or on statin Glucose >140 mg/dL (3 h OGTT)	25% (8/32)	Higher proportion of deceased donor grafts Increased frequency of acute rejections and use of steroid pulses BMI pre-transplant
Wilson et al. [12]	2010	≥3 criteria: BMI > 97th percentile BP > 95th percentile or on BP med HDL-C < 5th percentile or on statin TG > 95th percentile or on statin Fasting glucose >100 mg/dL or on insulin	18.8% at transplant (34/181) 37% at 1 year post-transplant (67/181)	Higher odds of LVH [OR 2.6 (95% CI 1.2–5.9)] Higher odds of eccentric hypertrophy [OR 3.0 (95% CI 1.2–7.6)]
Maduram et al. [8]	2010	≥3 criteria: BMI > 97th percentile BP > 95th percentile or on BP med HDL-C < 5th percentile TG > 95th percentile Fasting glucose > 100 mg/dL	68% in steroid group (17/25) 15% in steroid withdrawal group (5/33)	Lower GFR in children at 1 year post-transplant (65) versus those without MS (65 versus 88 mL/min/1.73 m2)
Tainio et al. [7]	2014	≥3 criteria: >120% median weight BP > 95th percentile or on BP med HDL-C < 40 mg/dL TG > 150 mg/dL Fasting glucose > 100 mg/dL	19% at 1.5 year post-transplant (28/147) 14.2% at 5 year post-transplant (18/127)	Lower GFR at 1.5 years but no difference at ≥5 years post-transplant

BP, blood pressure; HDL-C, high-density lipoprotein cholesterol; OGTT, oral glucose tolerance test; TG, triglycerides; WC, waist circumference.