Growth of long term survivors of liver transplantation
a Department of
Paediatrics, Addenbrooke's Hospital, Cambridge, UK, b Department of Adolescent Medicine, University
College London Hospitals and Great Ormond Street Hospital, London, UK, c MRC-Dunn Nutrition Unit,
Cambridge, UK
Correspondence to: Dr R M Viner, Director of Adolescent Medicine, Middlesex Hospital, Mortimer Street, London W1N 8AA, UK. email: R.Viner{at}ich.ucl.ac.uk
Accepted 9 July 1998
OBJECTIVE
To
assess growth in survivors of liver transplantation.
Study
designGrowth was
studied in 105 children up to seven years after liver transplantation.
ResultsAt
transplantation, mean height standard deviation score (zH) was 
1.22
but 19% of patients were severely growth retarded (height below 0.4th
centile). Growth and pubertal retardation were seen in the first six
months after liver transplantation. Significant catch up in growth and
puberty continued for more than five years. At five years, mean zH was
0.95 and at seven years 0.84. The mean zH of patients at final
height was 0.55. zH at six months was predicted by zH and bilirubin
at the time of transplantation and prednisolone dose at six months. At
four years, zH was predicted by zH at the time of transplantation and the cumulative prednisolone dose. There was no association between zH
and age at transplantation, sex, or diagnosis, although those with
biliary atresia and those undergoing transplantation under 2 years of
age showed more initial growth delay and subsequent catch up. Average
age at menarche was 14.2 years.
ConclusionsThe
mean height of the group to have reached final height after liver
transplantation was on the 27th centile. Those transplanted earlier in
childhood are likely to achieve more normal final heights. High steroid
dose, poor liver function, and retransplantation are associated with
poorer height outcomes. Persisting severe short stature is largely
confined to children with severely retarded growth at the time of
transplantation. Transient delay in puberty and menarche occur early
after transplantation, although appropriate pubertal progress is
resumed after two to three years.
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© 1999 by Archives of Disease in Childhood
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[Abstract] [Full Text] -
Taylor, R. M., Franck, L. S., Gibson, F., Dhawan, A.
(2005). Liver transplantation in children: part 2 - long-term issues. J Child Health Care
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