Evans IVR et al. (2005) Post-transplantation growth among pediatric recipients of liver transplantation. Pediatr Transplantation 9: 480–485

Children with end-stage liver disease (ESLD) are often growth retarded before and after liver transplantation. Evans and colleagues therefore investigated the growth patterns in 72 children who were included in the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database.

Children were selected for inclusion in this study if they were less than 16 years of age at transplantation and had survived for more than 1 year following transplantation. Height measurements were obtained at baseline, 4 months after transplantation and at 1-year intervals from the transplantation date. Final height measurements were taken at 7 years post-transplantation.

Children who waited more than 1 year for a transplantation following diagnosis of ESLD were significantly smaller than children who waited less than 1 year. Patients who were growth retarded before transplantation experienced a substantially larger increase in height per year than children who were not. Although most children experienced accelerated growth soon after transplantation, the increase was not sufficient for this group to match the median heights of peers of the same age and sex at the study endpoint.

In summary, this study indicates that liver transplantation alleviates growth retardation in children with ESLD to a certain degree. A complete return to normal height after an average of 7 years was not shown, however. The authors conclude that in order to minimize the degree of growth retardation in children with ESLD, liver transplantation should be performed as early as possible after diagnosis.