title: Recombinant human growth hormone improves growth in children receiving glucocorticoid treatment after liver transplantation.
abstract: Linear growth is often impaired after successful liver transplantation. The cause is multifactorial; poor graft function and long term glucocorticoid treatment are the main factors responsible. The efficacy and safety of recombinant human GH (rhGH) treatment were assessed in eight growth-retarded children (five boys and three girls) with liver transplants. Immunosuppression comprised azathioprine, cyclosporin, and methylprednisolone. rhGH was administered in a dose of 1 IU/kg x week, given by daily sc injections. The median age at the start of treatment was 9.7 yr (range, 5.9-14.9 yr). All but one of the patients remained prepubertal during treatment. The median growth rate increased from 3.2 to 7.l cm/yr (P = 0.025) and height SD score increased from -3.9 to -3.1 (P = 0.036) during the first year of rhGH treatment. Serum insulin-like growth factor I and insulin-like growth factor-binding protein-3 levels increased significantly during treatment. Graft function was normal in all except one patient, and no rejections or other serious side-effects were documented. In conclusion, rhGH treatment is effective in short, non-GH-deficient, liver-transplanted children receiving long term glucocorticoid treatment. Due to potential risk of allograft rejection, close monitoring of liver function and immunosuppression is required.
authors.affiliation: Children's Hospital, University of Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Sarna
authors.forename: I
authors.initials: I
authors.lastname: Sipilä
authors.forename: K
authors.initials: K
authors.lastname: Rönnholm
authors.forename: R
authors.initials: R
authors.lastname: Koistinen
authors.forename: C
authors.initials: C
authors.lastname: Holmberg
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006128:Growth / Q000187:drug effects*; D006130:Growth Disorders / Q000150:complications / Q000188:drug therapy*; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008991:Monitoring, Physiologic; D011994:Recombinant Proteins / Q000627:therapeutic use; D018709:Statistics, Nonparametric
chemical_list: D007166:Immunosuppressive Agents; D018972:Insulin-Like Growth Factor Binding Protein 3; D011994:Recombinant Proteins; D007334:Insulin-Like Growth Factor I; D016572:Cyclosporine; D013006:Growth Hormone; D001379:Azathioprine; D008775:Methylprednisolone