Long‐term outcome of liver transplantation in childhood: A study of 20‐year survivors. Issue 7 (12th January 2018)

• Record Type: Journal Article
• Authors: Martinelli, J.; Habes, D.; Majed, L.; Guettier, C.; Gonzalès, E.; Linglart, A.; Larue, C.; Furlan, V.; Pariente, D.; Baujard, C.; Branchereau, S.; Gauthier, F.; Jacquemin, E.; Bernard, O.
• Is Part Of: American journal of transplantation. Volume 18:Issue 7(2018)
• Page Start: 1680
• Page End: 1689
• Publication Date: 2018-01-12
• Subjects: clinical research/practice -- glomerular filtration rate (GFR) -- graft survival -- growth and development -- liver disease: congenital -- liver transplantation/hepatology -- patient survival -- pediatrics; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14626
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : We report the results of a study of survival, liver and kidney functions, and growth with a median follow‐up of 24 years following liver transplantation in childhood. From 1988 to 1993, 128 children underwent deceased donor liver transplantation (median age: 2.5 years). Twenty‐year patient and graft survival rates were 79% and 64%, respectively. Raised serum aminotransferase and/or γ‐glutamyl transferase activities were present in 42% of survivors after a single transplantation. Graft histology (35 patients) showed signs of chronic rejection in 11 and biliary obstruction in 5. Mean total fibrosis scores were 4.5/9 and 3/9 in patients with abnormal and normal serum liver tests, respectively. Glomerular filtration rate was <90 mL·min −1 in 35 survivors, including 4 in end‐stage renal disease who were undergoing dialysis or had undergone renal transplantation. Median final heights were 159 cm for women and 172 cm for men; final height was below the target height in 37 patients. Twenty‐year survival after childhood liver transplantation may be close to 80%, and final height is within the normal range for most patients. However, chronic kidney disease or altered liver biochemistries are present in over one third of patients, which is a matter of concern for the future. Abstract : Of 128 children who underwent liver transplantation between 1988 and 1993, 101 were alive 20 to 28 years later, including 10 who displayed stage 3 to 5 chronic kidney disease.