Sustained linear growth and preserved renal function in 10-year survivors of pediatric liver transplantation

Area of Science:

• Pediatric Hepatology
• Transplantation Medicine
• Clinical Outcomes Research

Background:

• Liver transplantation (LT) is a life-saving procedure for children with end-stage liver disease.
• Long-term outcomes beyond 10 years post-pediatric LT are less understood.
• Assessing sustained graft function and patient well-being is crucial for managing pediatric transplant recipients.

Purpose of the Study:

• To characterize the long-term clinical outcomes of pediatric liver transplant recipients surviving over 10 years.
• To evaluate graft function, growth, and incidence of major complications in this cohort.
• To identify factors contributing to successful long-term survival after pediatric LT.

Main Methods:

• Retrospective review of medical records for 44 pediatric patients who survived >10 years post-LT.
• Data collected included age at transplantation, donor type, indication for LT, immunosuppression, and clinical parameters.
• Analysis focused on graft function, growth (height z-score), and comorbidities (renal dysfunction, diabetes, hypertension).

Main Results:

• Biliary atresia was the most common indication (65.9%); living donor LT was predominant (41/44).
• At 10 years, 35 patients were on tacrolimus monotherapy, and 5 were off immunosuppression.
• Patients showed sustained linear growth (mean height z-score improved from -1.35 to 0.05) with low incidences of renal dysfunction (4.5%) and no need for antihypertensive or diabetes medications.

Conclusions:

• Pediatric liver transplantation offers excellent long-term survival with sustained graft function and remarkable linear growth.
• Low rates of renal dysfunction and metabolic complications suggest favorable long-term health in these survivors.
• Optimized immunosuppression strategies and living donor LT may contribute to these positive long-term outcomes.