Abstract
Changes of serum GH-binding protein (GHBP) levels in children with congenital biliary atresia were studied before and after living related liver transplantation (LT). Of 6 children, 3 showed growth retardation (less than −2 SDS of height) before LT. All of them were free from post-operative complication. Steroids were discontinued within the first 3 months. Blood samples were drawn before LT, 1, and 6 months after LT for determination of GHBP levels (ligand mediated immunofunctional assay) and plasma IGF-I levels (RIA, direct method). Preoperative GHBP levels were reduced for their age in 3 of the 6 patients, and IGF-I levels were less than 0.22 U/ml in all 6 children. No correlation was found neither between preoperative height SDS and preoperative GHBP level, nor between the former and preoperative IGF-I level. In the three children with decreased GHBP levels preoperatively, GHBP levels increased markedly a month after LT and stayed normal at 6 months. In the remaining 3 children with normal preoperative GHBP levels, two showed normal values throughout the observation period but one showed reduced serum GHBP level at 6 months after LT. Post-transplantation IGF-I levels were more than 10 times at one month and more than 4 times at 6 months compared with those of pre-transplantation in all but one patient. Height SDS evaluated at 6 months improved in 5 of 6 children. The patient who showed reduced GHBP level could not undergo postoperative catch-up growth in spite of the increased IGF-I level at 6 months. These findings suggest that the increase of GHBP and IGF-I after liver transplantation might reflect the regeneration of transplanted liver as well as the metabolic improvement. Long term observation would be necessary for evaluation of GHBP as an indicator of catch-up growth after liver transplantation.
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Yamanaka, C., Uemoto, S., Tanaka, K. et al. SERUM GH-BINDING PROTEIN BEFORE AND AFTER LIVER TRANSPLANTATION IN CHILDREN WITH CONGENITAL BILIARY ATRESIA. Pediatr Res 33 (Suppl 5), S52 (1993). https://doi.org/10.1203/00006450-199305001-00296
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DOI: https://doi.org/10.1203/00006450-199305001-00296