Abstract
To investigate outcome and evaluate areas of potential ongoing concern after orthotopic liver transplantation (OLT) in children, overall actuarial survival rates in relation to age and degree of undernutrition at the time of OLT have been evaluated and followup studies of growth parameters and quality of life undertaken in a group of 48 children (age 0.5-14.2 yr) undergoing OLT for end-stage liver disease. Overall 3 yr actuarial survival was 68%. Survival rates did not differ between age groups (actuarial 1 year survival for ages 5-15 yr, 1-5 yr and <1 yr were 68%, 72% and 62% respectively) but did differ according to nutritional status at OLT (actuarial 1 year survival for children with Z scores for weight <-1 was 58%, >-1 was 94% p=0.01)- Significant catchup weight gain and growth were observed by 6, 12 and 18 months post transplant (n=17). Of 28 survivors studied 12 months after OLT, quality of life was assessed by adaptive behaviour and social skills indices. In all but 3 cases, quality of life was judged to be excellent and all school aged children bar one were attending normal school. Two cases had intracerebral perioperative complications with mild to moderate intellectual handicap.
Satisfactory long term survival can be achieved after OLT in children regardless of age but the importance of preoperative nutrition is emphasized. Survivors have an excellent chance of good quality of life and cmchup growth by 1 year post-transplant.
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Cleehorn, G., Chin, S., Patrick, M. et al. SURVIVAL, GROWTH AND QUALITY OF LIFE AFTER LIVER TRANSPLANT IN CHILDREN. Pediatr Res 27, 538 (1990). https://doi.org/10.1203/00006450-199005000-00078
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DOI: https://doi.org/10.1203/00006450-199005000-00078