Differences in anthropometric parameters and the IFG-I-IGFBP3 axis between liver and renal transplant children.
BACKGROUND
Growth can be differently altered after liver and renal transplantation (Tx) in childhood.


METHODS
We compared graft function, linear growth, immunosuppression and serum IGF-I (RIA) and IGFBP3 (IRMA) concentrations in 15 liver (5.6+/-1.1 years old) and 17 renal (7.4+/-0.1 years old) Tx patients who were followed for 4-6 years.


RESULTS
Graft function was normal post-liver Tx, although in renal recipients creatinine clearance decreased significantly during follow-up. Liver Tx children presented an increase in mean height of 0.92+/-0.2 SDS (P<0.01) beyond the 2nd year post-Tx, although in renal Tx patients height SDS did not improve. Immunosuppressive corticoid dosage could be decreased and discontinued in liver Tx patients, while in renal recipients it was maintained between 0.18+/-0.01 and 0.16+/-0.02 mg/kg/day. At 3.7+/-0.4 years post Tx, liver Tx patients presented higher mean serum IGF-I level, lower mean serum IGFBP3 value, leading to a higher mean IGF-I/IGFBP3 molar ratio, P<0.001.


CONCLUSIONS
We found that while catch up growth coud be achieved after liver Tx, height SDS did not improve after renal Tx. This may be related to a reduced renal graft function and/or to differences in immunosuppressive corticoid dosage. In children with renal transplants a challenge for the future will reside in making it possible to substitute steroid therapy without altering graft function.
Pasqualini
T
T
Departamento de Pediatría, Hospital Italiano de Buenos Aires, Argentina.
Ferraris
J R
JR
Jasper
H
H
Pennisi
P
P
D'Agostino
D
D
D000293:Adolescent; D000367:Age Factors; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006128:Growth; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000473:pathology* / Q000502:physiology*; D016031:Liver Transplantation / Q000009:adverse effects / Q000473:pathology* / Q000502:physiology*; D008297:Male
D007166:Immunosuppressive Agents; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I