Evaluation of growth after liver transplantation in Turkish children
Masallah Baran1, Murat Cakir, Fatih Unal
1Department of Pediatric Gastroenterology Hepatology and Nutrition, Ege University, Bornova, Izmir, Turkey.
Insights
Liver transplantation (LT) in children significantly improves nutritional status and promotes growth, especially within the first year post-transplant. Factors like age and absence of rejection positively impact growth outcomes.
Area of Science:
- Pediatric Gastroenterology
- Transplant Surgery
- Pediatric Endocrinology
Background:
- Childhood liver transplantation (LT) aims to prevent long-term complications and optimize growth.
- Nutritional status and growth are critical indicators of health in pediatric patients undergoing LT.
Purpose of the Study:
- To analyze nutritional status in the pre-transplantation period for children.
- To evaluate post-transplantation growth and identify associated factors in pediatric liver transplant recipients.
Main Methods:
- Eighty children undergoing LT were studied.
- Height (Z(H)) and weight (Z(W)) Z-scores were calculated pre-transplant and up to 5 years post-transplant.
Main Results:
- Pre-transplant Z-scores for height and weight were -1.6 ± 1.3 and -1.5 ± 1.4, respectively.
- Post-LT, Z-scores improved significantly, particularly in the first 6 months, reaching above -1 at year 2 and -0.5 at year 4.
- Positive factors for growth included younger age at LT, specific primary diagnoses, lower steroid doses (<1,000 mg), and absence of rejection episodes.
Conclusions:
- Liver transplantation is a life-saving intervention that effectively facilitates growth in children.
- Optimized growth post-LT is an indispensable component of childhood health and recovery.
Aims:
Currently, the main interest in childhood liver transplantation (LT) is to prevent long-term complications and optimize growth. The aim of this study is to analyze (1) nutritional status in the pretransplantation period, and (2) posttransplantation growth and associated factors in children.
Patients And Methods:
Eighty children were included in the study. Height (Z (H)) and weight (Z (W)) Z scores were calculated before transplantation and postoperatively at the 6th month and 1st, 2nd, 3rd, 4th, and 5th year.
Results:
Patients' Z (H) and Z (W) scores at LT were -1.6 ± 1.3 and -1.5 ± 1.4, respectively. Both Z (H) and Z (W) scores increased after LT, especially in the first 6 months, and then continued to rise gradually. Both reached beyond -1 Z score at 2nd year and -0.5 at 4th year. Age, primary diagnosis, total steroid dose (<1,000 mg), and absence of rejection episodes had positive impact on posttransplantation growth, whereas gender, immunosuppression type, surgical complications, and presence of tumor had no impact on posttransplantation growth. Age at time of LT was negatively correlated with Z (W) score at 5th year (P = 0.02, r = -0.43). Both Z (W) and Z (H) scores at time of LT were positively correlated with Z (W) and Z (H) scores and negatively correlated with ∆Z (W) and ∆Z (H) scores at 5th year.
Conclusions:
LT is not only a modern, life-saving treatment technique but also an efficient method of facilitating growth, an indispensable component of childhood and the best indicator of health.
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