[Management of pediatric patients who underwent liver transplantation].
OBJECTIVE
To evaluate the outcome of pediatric patients who underwent liver transplantation between Oct. 2002 and May 2005 in the Pediatric Hospital.


METHODS
Eight cases aged from 4 to 67 months who underwent liver transplantation were analyzed retrospectively. Four of the patients were boys and 4 girls, whose body weight at the time of liver transplantation was 6-19 kg. The underlying diseases were biliary atresia, congenital cholestasis, drug-induced cholestatic cirrhosis and cryptogenic cirrhosis. These patients had been followed up for blood routine examinations, liver and renal function, serum electrolytes and blood concentration of tacrolimus for 16 to 43 months after liver transplantation. Results of serological studies for viral etiology, liver biopsy, growth and mental development were also recorded.


RESULTS
One-year survival rate was 75.0% with the longest survival time being 43 months after transplantation. One patient died from renal failure due to postoperative bleeding 24 hours after the surgery and another case died of variceal hemorrhage 8 months after transplantation. Posttransplantation complications included acute cellular rejection, viral infection and hypoalbuminemia. Viral infections included cytomegalovirus infection in 3 cases, Epstein-Barr virus infection in 1 and hepatitis B virus infection in 1. Surgical complications of portal vein thrombosis and stenosis of inferior vena cava and hepatic vein occurred in 2 cases respectively. Side effects of tacrolimus including hypertension, renal damage, liver damage and diarrhea were observed. Significant growth-retardation was not often seen. A self-reported high quality of life was common.


CONCLUSIONS
Close follow-up and management of patients after liver transplantation may significantly increase the survival rate and improve quality of life in children with end-stage liver diseases.
Wang
Zhong-Lin
ZL
Department of Infectious Diseases, Pediatric Hospital, Fudan University, Shanghai 200032, China.
Wang
Xiao-Hong
XH
Zheng
Shan
S
D001656:Biliary Atresia / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000209:etiology*; D006509:Hepatitis B / Q000209:etiology; D004854:Herpesvirus 4, Human; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D017093:Liver Failure / Q000150:complications* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D010372:Pediatrics; D011183:Postoperative Complications; D015996:Survival Rate; D016559:Tacrolimus / Q000009:adverse effects*; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000002:abnormalities; D020246:Venous Thrombosis / Q000209:etiology
D007166:Immunosuppressive Agents; D016559:Tacrolimus