Sensorineural hearing loss in children after liver transplantation.
OBJECTIVE
To investigate risk factors for sensorineural hearing loss (SNHL) in children after liver transplantation.


METHODS
Retrospective medical record review.


METHODS
Pediatric tertiary care hospital.


METHODS
One hundred twenty-five consecutive children who received liver transplants between March 1, 1987, and June 30, 1996.


METHODS
The presence of SNHL (bone conduction threshold of >35 dB of hearing loss in at least 1 frequency) and the cause of the liver abnormality in all 125 patients. In addition, among the subset of children who had biliary atresia and underwent transplantation before 2 years of age, the total dose (milligrams per kilogram of body weight) of aminoglycoside antibiotic medications (tobramycin sulfate, gentamicin sulfate, and amikacin sulfate) and of intravenous loop diuretic agents (furosemide) was compared between children with and without SNHL.


RESULTS
Audiologic evaluations were available for 66 of 125 patients, 15 (12%) of whom have SNHL. Of 5 survivors with the short-bowel syndrome, 4 have severe to profound SNHL. Of 46 children who have biliary atresia and who underwent transplantation before 2 years of age, 8 (17%) have SNHL. Among the 26 evaluable children with biliary atresia undergoing liver transplantation before 2 years of age, logistic regression analysis revealed that the most important risk factor for SNHL was the cumulative dose of amikacin (P = .05).


CONCLUSIONS
Children receiving liver transplants are at an increased risk for SNHL. Those with the short-bowel syndrome have the greatest prevalence of SNHL. Among the subset of children with biliary atresia receiving liver transplants before 2 years of age, statistical analysis demonstrates a dose-response relationship between the receipt of amikacin and the occurrence of SNHL.
Deutsch
E S
ES
Department of Otorhinolaryngology, Temple University School of Medicine and St Christopher's Hospital for Children, Philadelphia, PA, USA. edeutsch@aidi.nemours.org
Bartling
V
V
Lawenda
B
B
Schwegler
J
J
Falkenstein
K
K
Dunn
S
S
D001299:Audiometry; D001656:Biliary Atresia / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000209:etiology; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D016015:Logistic Models; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000601:surgery