Children do well 5 years after liver transplant

NEW YORK (Reuters Health) - New research indicates that most children who are 5-year survivors of liver transplantation have good graft function; however, chronic medical conditions and complications affecting other organs are common in this patient population.

“The success of liver transplantation in children is defined by more than just excellent survival rates. Better understanding of the long-term medical considerations is of critical importance in pediatric liver transplant recipients, who by nature of their young age face a greater cumulative burden of life-long immunosuppression,” Dr. Vicky Lee Ng and co-researchers emphasize in their report in the journal Pediatrics.

Liver transplantation has been the standard of care for life-threatening liver diseases for more than two decades, yet multicenter data regarding the long-term outcomes have been lacking, Ng, from the University of Toronto, and associates point out.

The current investigation included 461 patients who survived longer than 5 years after undergoing a liver transplant at 1 of 45 pediatric centers across North America between 1996 and 2001.

Overall, 88 percent of the patients survived with their first liver transplant, while 12 percent required one or two additional attempts.

Most patients had a functional liver at their 5-year clinic assessment, the report indicates. For immunosuppressive therapy, given to prevent organ rejection, most patients - 97 percent - received a calcineurin inhibitor and 25 percent were prescribed prednisone.

The risk of having an episode of sudden cellular rejection within 5 years was 60 percent. Gradual continuous, or chronic, rejection also occurred in 5 percent of the patients, the authors note.

Six percent of the children developed posttransplant lymphoproliferative disease, an increased production of lymphocytes, which is normally seen as a response to infection. Thirteen percent of the subjects had signs of possible kidney disease.

After accounting for the effects of age and gender, 12 percent of the subjects had a weight that was above the 95th percentile and 29 percent had a height below the 10th percentile.

“This study emphasizes the need for a collaborative partnership between primary care practitioners and pediatric healthcare providers both beyond and within transplant centers to further improve outcomes for pediatric liver transplant recipients,” the researchers conclude.

SOURCE: Pediatrics, December 2008.


Related Posts:

NEW YORK (Reuters Health) - People who undergo liver transplantation, particularly children, are at increased risk for developing cancer, Finnish researchers report in the journal Liver Transplantation. “On the basis of our data,” Dr. Fredrik Aberg, from the Helsinki University Central Hospital, and co-authors note, “1 of 6 liver transplant patients is estimated to develop some

Full Post: Cancer common after liver transplantation

By Will Boggs, MD NEW YORK (Reuters Health) - People hoping for a liver transplant and who are obese face prolonged waiting times, reflecting a possible “reluctance to transplant obese patients,” according to a new report. “In transplantation, outcomes are available online to the general public, and compared from hospital to hospital,” Dr. Dorry L. Segev explained

Full Post: Obese patients wait longer for liver transplant

NEW YORK (Reuters Health) - Advanced donor age, per se, does not adversely affect the transplant recipient or the survival of the organ after liver transplantation, according to a report in the Journal of the American College of Surgeons. Previous reports have indicated that the age of the donor — older than 60 years - contributes

Full Post: Liver transplants from elderly donors are safe

By Jim Loney MIAMI (Reuters) - An American teen-ager survived for nearly four months without a heart, kept alive by a custom-built artificial blood-pumping device, until she was able to have a heart transplant, doctors in Miami said on Wednesday. The doctors said they knew of another case in which an adult had been kept alive in

Full Post: U.S. teen lives 118 days without heart

NEW YORK (Reuters Health) - An organ allocation policy that puts the sickest patients first in line to receive available donor livers for transplantation has created some unintended consequences for those patients low on the organ wait list, research suggests. Since the new donor organ allocation system was implemented in early 2002, there has been a

Full Post: Policy has changed how organs are allocated

Site Navigation

Most Read