Long-term outcome of liver transplantation in childhood: A study of 20-year survivors

J. Martinelli, D. Habes, L. Majed, C. Guettier, E. Gonzalès, A. Linglart, C. Larue, V. Furlan, D. Pariente, C. Baujard, S. Branchereau, F. Gauthier, E. Jacquemin, O. Bernard

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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.

Original languageEnglish
Pages (from-to)1680-1689
Number of pages10
JournalAmerican Journal of Transplantation
Volume18
Issue number7
DOIs
Publication statusPublished - 1 Jul 2018
Externally publishedYes

Keywords

  • clinical research/practice
  • glomerular filtration rate (GFR)
  • graft survival
  • growth and development
  • liver disease: congenital
  • liver transplantation/hepatology
  • patient survival
  • pediatrics

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