title: [Evolution of children one year post liver transplant].
abstract: Orthotopic liver transplantation is the only definitive mode of therapy for children with end-stage liver disease. However, it remains challenging because of the necessity to prevent long-term complications. The aim of this study was to analyze the evolution of transplanted patients with more than one year of follow up. Between November 1992 and November 2001, 238 patients underwent 264 liver transplantations. A total of 143 patients with more than one year of follow up were included. The median age of patients +/- SD was 5.41 years +/- 5.26 (r: 0.58-21.7 years). All children received primary immunosuppression with cyclosporine. The indications for liver replacement were: fulminant hepatic failure (n: 50), biliary atresia (n: 38), cirrhosis (n: 37), chronic cholestasis (n: 13) and miscellaneous (n: 5). The indications for liver re-transplantation were: biliary cirrhosis (n: 7), hepatic artery thrombosis (n: 4) and chronic rejection (n: 3). Reduced-size liver allografts were used in 73/157 liver transplants, 14 of them were from living-related donors and 11 were split-livers. Patient and graft survival rates were 93% and 86% respectively. Death risk was statistically higher in retransplanted and reduced-size grafted patients. Growth retardation and low bone density were recovered before the first 3 years post-transplant. The incidence of lymphoproliferative disease was 7.69%. De novo hepatitis B was diagnosed in 7 patients (4.8%). Social risk did not affect the outcome of our population. The prevention, detection and early treatment of complications in the long-term follow up contributed to improve the outcome.
authors.affiliation: Hospital de Pediatría Juan P. Garrahan, Buenos Aires. mcuarterolo@intramed.net
authors.forename: Miriam
authors.initials: M
authors.lastname: Cuarterolo
authors.forename: Mirta
authors.initials: M
authors.lastname: Ciocca
authors.forename: Susana
authors.initials: S
authors.lastname: López
authors.forename: Guillermo
authors.initials: G
authors.lastname: Cervio
authors.forename: Luis
authors.initials: L
authors.lastname: Rojas
authors.forename: Gustavo
authors.initials: G
authors.lastname: Bianco
authors.forename: Ana
authors.initials: A
authors.lastname: Speranza
authors.forename: Jorge
authors.initials: J
authors.lastname: Sasbon
authors.forename: María T G
authors.initials: MT
authors.lastname: De Davila
authors.forename: Horacio
authors.initials: H
authors.lastname: Questa
authors.forename: Jose
authors.initials: J
authors.lastname: Lipsich
authors.forename: David
authors.initials: D
authors.lastname: Bes
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernandez
authors.forename: Marcelo
authors.initials: M
authors.lastname: Dip
authors.forename: Victor
authors.initials: V
authors.lastname: Ayarzabal
authors.forename: Cristina
authors.initials: C
authors.lastname: Tau
authors.forename: Elisa
authors.initials: E
authors.lastname: Vaiani
authors.forename: Mariana
authors.initials: M
authors.lastname: Del Pino
authors.forename: Matias
authors.initials: M
authors.lastname: Oleastro
authors.forename: Norma
authors.initials: N
authors.lastname: Delgado
authors.forename: Virginia
authors.initials: V
authors.lastname: Delfino
authors.forename: Enrique
authors.initials: E
authors.lastname: Bravo
authors.forename: Eduviges
authors.initials: E
authors.lastname: Norton
authors.forename: Oscar
authors.initials: O
authors.lastname: Imventarza
mesh_terms: D001118:Argentina / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome