Factors Associated With Growth After Deceased and Live Donor Pediatric Liver Transplantation

Oya M. Andacoglu, Amber Himmler, Xue Geng, Jaeil Ahn, Elizabeth Conlon, Khalid Khan, Nada Yazigi, Thomas M. Fishbein

Research output: Contribution to journalArticle

Abstract

Background: There are limited data on predictors of growth after pediatric liver transplantation. Methods: We reviewed the impact of graft type, ethnicity, and biliary complications (BC) on growth after pediatric liver transplantation (LT). We compared preoperative and 6-, 12-, and 24-month weight, height, and body mass index (BMI) percentiles between living donor (LD), deceased donor full-size (DD-full), and deceased donor split (DD-split) graft recipients. We also compared length of stay (LOS) between groups. Results: We had 98 patients (DD-split: 32; DD-full: 43, LD: 23). The Median Pediatric End-stage Liver Disease (PELD) scores, exception points, albumin, bilirubin, failure to thrive, and presence of ascites were similar among groups. The DD-full group had the lowest preoperative percentiles in all categories and exceeded these at 24 months. The DD-split group was at preoperative percentiles at 24 months. The LD group had parallel weight curves compared to the DD-full group and exceeded only the preoperative weight percentile at 24 months. Black patients had the lowest percentiles in all categories (P <.01). The BC group caught up weight and BMI percentile at 24 months but had persistent decrease in height percentiles. Patients without BC exceeded preoperative height percentiles. The longer LOS group had lower height and BMI percentiles at 24 months; however, there was no statistical difference. Conclusion: DD-full and black patients seem to benefit the most from LT in terms of growth. BC seems to affect height percentiles. Patients with longer LOS had lower height and BMI percentiles (P>.05). Longer follow up and larger cohorts are necessary to improve the power of these findings.

Original languageEnglish (US)
Pages (from-to)3059-3066
Number of pages8
JournalTransplantation Proceedings
Volume51
Issue number9
DOIs
StatePublished - Nov 2019

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Liver Transplantation
Tissue Donors
Pediatrics
Growth
Living Donors
Weights and Measures
Transplants
Failure to Thrive
End Stage Liver Disease
Bilirubin
Ascites
Albumins
Length of Stay
Body Mass Index

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Factors Associated With Growth After Deceased and Live Donor Pediatric Liver Transplantation. / Andacoglu, Oya M.; Himmler, Amber; Geng, Xue; Ahn, Jaeil; Conlon, Elizabeth; Khan, Khalid; Yazigi, Nada; Fishbein, Thomas M.

In: Transplantation Proceedings, Vol. 51, No. 9, 11.2019, p. 3059-3066.

Research output: Contribution to journalArticle

Andacoglu, Oya M. ; Himmler, Amber ; Geng, Xue ; Ahn, Jaeil ; Conlon, Elizabeth ; Khan, Khalid ; Yazigi, Nada ; Fishbein, Thomas M. / Factors Associated With Growth After Deceased and Live Donor Pediatric Liver Transplantation. In: Transplantation Proceedings. 2019 ; Vol. 51, No. 9. pp. 3059-3066.
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AU - Himmler, Amber

AU - Geng, Xue

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AU - Conlon, Elizabeth

AU - Khan, Khalid

AU - Yazigi, Nada

AU - Fishbein, Thomas M.

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N2 - Background: There are limited data on predictors of growth after pediatric liver transplantation. Methods: We reviewed the impact of graft type, ethnicity, and biliary complications (BC) on growth after pediatric liver transplantation (LT). We compared preoperative and 6-, 12-, and 24-month weight, height, and body mass index (BMI) percentiles between living donor (LD), deceased donor full-size (DD-full), and deceased donor split (DD-split) graft recipients. We also compared length of stay (LOS) between groups. Results: We had 98 patients (DD-split: 32; DD-full: 43, LD: 23). The Median Pediatric End-stage Liver Disease (PELD) scores, exception points, albumin, bilirubin, failure to thrive, and presence of ascites were similar among groups. The DD-full group had the lowest preoperative percentiles in all categories and exceeded these at 24 months. The DD-split group was at preoperative percentiles at 24 months. The LD group had parallel weight curves compared to the DD-full group and exceeded only the preoperative weight percentile at 24 months. Black patients had the lowest percentiles in all categories (P <.01). The BC group caught up weight and BMI percentile at 24 months but had persistent decrease in height percentiles. Patients without BC exceeded preoperative height percentiles. The longer LOS group had lower height and BMI percentiles at 24 months; however, there was no statistical difference. Conclusion: DD-full and black patients seem to benefit the most from LT in terms of growth. BC seems to affect height percentiles. Patients with longer LOS had lower height and BMI percentiles (P>.05). Longer follow up and larger cohorts are necessary to improve the power of these findings.

AB - Background: There are limited data on predictors of growth after pediatric liver transplantation. Methods: We reviewed the impact of graft type, ethnicity, and biliary complications (BC) on growth after pediatric liver transplantation (LT). We compared preoperative and 6-, 12-, and 24-month weight, height, and body mass index (BMI) percentiles between living donor (LD), deceased donor full-size (DD-full), and deceased donor split (DD-split) graft recipients. We also compared length of stay (LOS) between groups. Results: We had 98 patients (DD-split: 32; DD-full: 43, LD: 23). The Median Pediatric End-stage Liver Disease (PELD) scores, exception points, albumin, bilirubin, failure to thrive, and presence of ascites were similar among groups. The DD-full group had the lowest preoperative percentiles in all categories and exceeded these at 24 months. The DD-split group was at preoperative percentiles at 24 months. The LD group had parallel weight curves compared to the DD-full group and exceeded only the preoperative weight percentile at 24 months. Black patients had the lowest percentiles in all categories (P <.01). The BC group caught up weight and BMI percentile at 24 months but had persistent decrease in height percentiles. Patients without BC exceeded preoperative height percentiles. The longer LOS group had lower height and BMI percentiles at 24 months; however, there was no statistical difference. Conclusion: DD-full and black patients seem to benefit the most from LT in terms of growth. BC seems to affect height percentiles. Patients with longer LOS had lower height and BMI percentiles (P>.05). Longer follow up and larger cohorts are necessary to improve the power of these findings.

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