J Korean Med Sci.  2005 Oct;20(5):835-840. 10.3346/jkms.2005.20.5.835.

Long-term Growth of Pediatric Patients Following Living-Donor Liver Transplantation

• Park SJ
• Rim SH
• Kim KM
• Lee JH
• Choi BH
• Lee SY
• Chang SH
• Lee YJ
• Lee SG

• KMID: 1781768
• DOI: http://doi.org/10.3346/jkms.2005.20.5.835

Abstract

In order to determine the influence of living donor liver transplantation (LDLT) on long-term growth, we studied the progress of 36 children who had survived more than 5 yr after LDLT from 1994 to 1999. The median age at the transplantation was 1.5 yr (range: 6 months-15 yr) and the median follow-up period was 6.5 yr (range: 5-9 yr). A height standard deviation score (zH) was analyzed for each patient according to medical records. Significant catch-up growth occurred within 2 yr after LDLT with a mean zH changing from -1.2 to 0.0 and was maintained for up to 7 yr post-transplantation (zH-0.1). Younger children (<2 yr) were more growth-retarded at the time of LDLT, but showed higher catch-up growth rates and their final zH was greater than that of older children. Children with liver cirrhosis were more growth-retarded at the time of LDLT, but showed significant catch-up growth and their final height was similar to children with fulminant hepatitis. Growth in children who experienced significant hepatic dysfunction after LDLT was not significantly different from those without graft dysfunction. There was no difference between the types of immunosuppressants used. Our finding suggests that LDLT can result in adequate catchup linear growth, and this effect can persist even after 7 yr post-transplantation.

Keyword

Living Donor; Liver Transplantation; Child; Growth

MeSH Terms

Adolescent
*Body Height
Child
*Child Development
Child, Preschool
Female
Humans
Infant
Korea/epidemiology
Liver Transplantation/*statistics and numerical data
*Living Donors
Longitudinal Studies
Male

Figure

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  Fig. 1 Post-transplantation mean height standard deviation scores (zH) of all children in the study.

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  Fig. 2 Post-transplantation mean height standard deviation scores (zH) of children under 6 yr of age at the time of transplantation.

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  Fig. 3 Post-transplantation mean height standard deviation scores (zH) of children with retarded (•) and normal growth (▪).

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  Fig. 4 Post-transplantation mean height standard deviation scores (zH) of children with retarded growth in the younger (<2 yr) (•) and older age (▪) groups.

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  Fig. 5 Post-transplantation mean height standard deviation scores (zH) of children with fulminant hepatitis (•) and liver cirrhosis (▪).

• 

  Fig. 6 Post-transplantation mean height standard deviation scores (zH) of children with episodes of chronic graft dysfunction (•) and normal hepatic function (▪).

• 

  Fig. 7 Post-transplantation mean height standard deviation scores (zH) of children with prednisolone and cyclosporin (•) or FK 506 (▪).

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