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Published on: August 17, 2022
Post-transplantation growth among pediatric recipients of liver transplantation
Idris V R Evans1, Steven H Belle, Yuling Wei
1University of Pittsburgh, Graduate School of Public Health, PA 15261, USA. evansi@edc.pitt.edu
Insights
Pediatric liver transplant recipients who waited longer for surgery were smaller initially. However, those with growth issues at transplant showed greater height gains post-surgery, improving their quality of life.
Area of Science:
- Pediatric Gastroenterology
- Transplantation Medicine
- Growth and Development
Background:
- Improving pediatric liver transplant recipients' quality of life is crucial.
- Restoring normal growth patterns is a key aspect of post-transplant QOL.
- Understanding growth trajectories informs clinical management and outcomes.
Purpose of the Study:
- To describe and analyze post-transplantation growth patterns in pediatric liver recipients.
- To identify factors influencing growth velocity and final height after liver transplantation.
- To compare growth outcomes based on pre-transplant waiting time and growth status.
Main Methods:
- Utilized multilevel models to analyze growth data from 72 children in the NIDDK-LTD.
- Compared height at transplantation based on waiting time ( 1 year).
- Assessed yearly height increase in relation to pre-transplant growth retardation and age/sex at transplantation.
Main Results:
- Children waiting > 1 year for transplantation were smaller at the time of surgery compared to those waiting < 1 year.
- Growth-retarded children experienced a greater yearly increase in height post-transplantation.
- Older boys (2-13 years) and girls (2-11 years) at transplant showed less growth retardation compared to those transplanted before age 2.
Conclusions:
- Waiting time for liver transplantation impacts initial size, but not necessarily long-term growth potential.
- Pre-transplant growth status is a significant predictor of post-transplant height velocity.
- Age at transplantation influences the degree of growth retardation, highlighting the importance of timely intervention.
Abstract:
Improving a patient's quality-of-life (QOL) post-liver transplantation is of great importance. An aspect of improved QOL is the restoration of normal growth patterns in pediatric patients. To describe the post-transplantation growth patterns of 72 children included in the National Institute of Diabetes and Digestive and Kidney Diseases - Liver Transplantation Database (NIDDK-LTD), multilevel models were used, according to which children who waited more than a year for transplantation were smaller, compared with age and sex matched peers, at transplantation than children who waited less than a year while children who were growth retarded at transplantation experienced a larger yearly comparison height increase than children who were not growth retarded. The analysis also showed that boys older than 2 yr and younger than 13 yr at transplantation and girls older than 2 yr and younger than 11 yr at transplantation were significantly less growth retarded at transplantation than boys and girls under the age of 2 yr at transplantation.
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