医学
肝移植
移植
期限(时间)
回顾性队列研究
儿科
外科
物理
量子力学
作者
Kentaro Umemura,Atsuyoshi Mita,Yasunari Ohno,Yuichi Masuda,Kazuki Yoshizawa,Kôji Kubota,Tsuyoshi Noguchi,Kiyotaka Hosoda,Koya Yasukawa,Atsushi Kamachi,Takamune Goto,Hidenori Tomida,Shiori Yamazaki,Akira Shimizu,Yuji Soejima
出处
期刊:Transplantation
[Ovid Technologies (Wolters Kluwer)]
日期:2024-02-20
卷期号:108 (3): 732-741
标识
DOI:10.1097/tp.0000000000004795
摘要
Background. Children requiring liver transplantation generally have severe growth retardation. Recipients experience posttransplantation catch-up growth, although some show short adult heights. We aimed to determine decades-long catch-up growth trends and risk factors for short adult height following liver transplantation. Methods. We analyzed long-term height Z scores and risk factors for short adult height in a single-center retrospective cohort of 117 pediatric liver transplantation recipients who survived >5 y, with 75 of them reaching adult height. Results. Median age at transplantation was 1.3 y, and the most common primary diagnosis was biliary atresia (76.9%). Mean height Z scores pretransplantation and 1, 3, and 8 y after transplantation were –2.26, –1.59, –0.91, and –0.59, respectively. The data then plateaued until 20 y posttransplantation when mean adult height Z score became –0.88, with a median follow-up of 18.6 y. Nineteen recipients did not show any catch-up growth, and one quarter of recipients had short adult height (<5th percentile of the healthy population). Multivariate analysis identified old age (odds ratio, 1.22 by 1 y; P = 0.002), low height Z scores at transplantation (odds ratio, 0.46 by 1 point; P < 0.001), and posttransplantation hospital stay ≥60 d (odds ratio, 4.95; P = 0.015) as risk factors for short adult height. In contrast, prolonged steroid use after transplantation was not considered a significant risk factor. Conclusions. Although tremendous posttransplantation catch-up growth was observed, final adult height remained inadequate. For healthy physical growth, liver transplantation should be performed as early as possible, before growth retardation becomes severe.
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