Growth and final height after liver transplantation during childhood.
OBJECTIVE
To evaluate the effect of end-stage pediatric liver disease and liver transplantation on growth and final height.


METHODS
We evaluated growth at 2 years (n = 101) and 5 years (n = 63) after pediatric liver transplantation (LTx). Twenty-three children reached final height. Height was expressed as a standard deviation score of the target height (zTH score) of each patient.


RESULTS
At the first 2 years after LTx, the zTH score was significantly increased from -1.7 to -1.3 SD (P < 0.05). Growth at 2 or 5 years after LTx, expressed as DeltazTH score, was positively correlated with pretransplant growth retardation (P < 0.05). In comparison with patients with noncholestatic primary liver disease, patients with cholestatic primary liver disease were more severely growth retarded before LTx (zTH score -2.0 vs -1.2 SD, P < 0.05) and had better growth in the first 2 years after LTx (DeltazTH score +0.6 vs -0.1 SD, P < 0.05). Twelve of the 23 patients had a final height below -1.3 SD of their target height.


CONCLUSIONS
Growth retardation is common in children before LTx, particularly in children with an underlying cholestatic disease. After LTx, catch-up growth was partial and was prominent only in cholestatic children who had been severely growth retarded before LTx. After LTx during childhood, approximately 50% of patients reach a final height lower than -1.3 SD of their genetic potential.
Scheenstra
Rene
R
Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands. r.scheenstra@bkk.umcg.nl
Gerver
Willem Jan
WJ
Odink
Roelof J
RJ
van Soest
Hanneke
H
Peeters
Paul M J G
PM
Verkade
Henkjan J
HJ
Sauer
Pieter J J
PJ
D000293:Adolescent; D001827:Body Height / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006128:Growth / Q000502:physiology*; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000601:surgery / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D013997:Time Factors