title: Follow-Up of Pediatric Liver Transplant Patients After Reaching Adulthood.
abstract: BACKGROUND Despite excellent transplantation results, there is a vulnerable period of time in the post-transplant management of pediatric liver recipients, which is the time when a child becomes an adolescent. This period of psychological distress influences compliance and may result in premature transplant failure and graft loss. We performed a retrospective review of pediatric liver transplant recipients, transferred to our service for adults, in order to identify key issues associated with transition into the adult care. MATERIAL AND METHODS We analyzed medical files of 20 liver recipients transferred from pediatric post-transplant outpatient clinic to the post-transplant service for adults, since year 2000 until December 2015. For survival analyses, Kaplan-Meier model with log-rank test and Cox proportional hazards regression model, to calculate hazard ratio (HR), were used. RESULTS Survival rate exceeds 90% in the study population. The major complication was late acute rejection, in most instances due to non-compliance. There were single cases of recurrent liver disease and de novo graft disorders. CONCLUSIONS Dedicated service for young people may be needed to optimize outcomes.
authors.affiliation: Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Justyna
authors.initials: J
authors.lastname: Rajchert
authors.affiliation: Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Rosa
authors.affiliation: Department of Gastroenterology, Hepatology and Eating Disorders, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Pawłowska
authors.affiliation: Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Milosz
authors.initials: M
authors.lastname: Parczewski
authors.affiliation: Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Wawrzynowicz-Syczewska
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality / Q000523:psychology; D008297:Male; D010349:Patient Compliance; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult