title: Quality of life and problems affecting recipients more than 10 years after living donor liver transplantation.
abstract: BACKGROUND
  We initiated living donor liver transplantation (LDLT) in 1991, allowing us to examine issues related to long-term survival. The aim of this study was to review the long-term outcomes of LDLT in children.
  
  
  METHODS
  We performed 116 LDLT from 1991 to present, including 17 recipients who survived >10 years. They were evaluated for growth, immunosuppressive therapy, complications, and quality of life (QOL).
  
  
  RESULTS
  The average age at LDLT was 5.4 years (range, 6 months to 17 years), with a present average age of 17.2 years (range, 11-28 years). At the time of LDLT, 6 recipients had growth retardation with body weights low for age by 2 standard deviations (SD). However, 4 of 6 recipients who underwent LDLT before age of 2 years caught up, reaching average heights and body weights for their ages. Among 6 recipients who were diagnosed with acute rejections by biopsy >5 years after LDLT, 5 improved after steroid pulse therapy. One recipient with a steroid-resistant acute rejection was administered deoxyspergualin after steroids. Chronic rejection was not observed in this series. One recipient has not required immunosuppressive therapy for >4 years with a good present condition.
  
  
  CONCLUSIONS
  The majority of LDLT recipients achieved a good QOL during long-term survival; they are pursuing normal studies.
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan. kawan@mail.tains.tohoku.ac.jp
authors.forename: N
authors.initials: N
authors.lastname: Kawagishi
authors.forename: I
authors.initials: I
authors.lastname: Takeda
authors.forename: S
authors.initials: S
authors.lastname: Miyagi
authors.forename: K
authors.initials: K
authors.lastname: Satoh
authors.forename: Y
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: S
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: S
authors.initials: S
authors.lastname: Satomi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006130:Growth Disorders / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000276:immunology* / Q000523:psychology; D019520:Living Donors; D008232:Lymphoproliferative Disorders / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents