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Published on: July 31, 2016
Transient hyperphosphatasemia after pediatric liver transplantation
Koichiro Yoshimaru1, Toshiharu Matsuura1, Makoto Hayashida1
1Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Transient hyperphosphatasemia (TH) is a temporary elevation of serum alkaline phosphatase (ALP) in children. In liver transplant recipients, TH shows a higher prevalence and can be diagnosed early by detecting the fast α2 band.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Clinical Chemistry
Background:
- Transient hyperphosphatasemia (TH) is characterized by temporary elevated serum alkaline phosphatase (ALP) without other liver function test (LFT) abnormalities.
- The fast α2 band on agarose gel electrophoresis is a sensitive marker for TH.
- The incidence of TH in healthy children is 1.5-2.8%.
Purpose of the Study:
- To investigate the characteristics of transient hyperphosphatasemia (TH) in pediatric patients following liver transplantation (LT).
Main Methods:
- Retrospective analysis of 5 pediatric patients (6.0%) who developed TH after LT between 1996 and 2014.
- Evaluation of patient background, TH duration, peak ALP levels, ALP isoenzyme, other LFTs, and imaging results.
Main Results:
- Median age at peak ALP was 24 months; mean TH duration was 111 days.
- All patients exhibited elevated ALP (median 6887 IU/L) without other LFT abnormalities.
- The fast α2 band was detected in all TH patients and normalized with ALP.
- TH prevalence was significantly higher in LT patients than in healthy children (P < 0.05).
Conclusions:
- The fast α2 band aids in early TH diagnosis post-LT.
- A 3-4 month follow-up period without intervention is a feasible management strategy for TH after LT.
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