Health status ten years after pediatric liver transplantation--looking beyond the graft

[Guest guest]

Transplantation. 2004 Aug 27;78(4):566-73.

Health status ten years after pediatric liver transplantation--looking

beyond the graft.

Avitzur Y, De Luca E, Cantos M, Jimenez- C, N, Fecteau A, Grant

D, Ng VL.

Paediatric Academic Multi-Organ Transplantation (PAMOT) Program, Hospital

for Sick Children, University of Toronto, Toronto, Canada.

BACKGROUND: Little is known about long-term health after pediatric

orthotopic liver transplantation (OLT). This study aimed to characterize the

health status of recipients 10 years after OLT, with an emphasis on

transplant-related morbidity and quality of life. METHODS: We performed a

retrospective database review of 32 children who underwent OLT before

October 1992 at one center and were alive after 10 years. Outcome measures

were assessed 10 years after OLT. Cantril's self-anchoring scale was used

for global quality of life assessment. RESULTS: Synthetic liver function at

10 years was preserved in all patients. The annual rate of episodes of acute

rejection dropped markedly after the first year (1.4 at year 1 to 0.19

rejections/patient/year at year 10). Histologically confirmed chronic

rejection developed in eight (25%) patients. At 10 years, long-term

complications included mild to severe chronic renal failure (77%), mild

chronic anemia (59%), and hypertension (25%). Significant growth retardation

(z-score < -2), hyperlipidemia, and diabetes were uncommon. Infection

requiring hospitalization occurred in 81% of the patients, with varicella

zoster virus as the most common pathogen. Epstein-Barr virus-related

malignancies affected 22% of patients. Ten-year survivors perceived quality

of life as very good. Self-reporting of drug nonadherence by seven (22%)

adolescents may have contributed to development of late onset rejection in

this subgroup. Conclusions. Children who are 10-year survivors of OLT have

excellent graft function and, despite chronic extrahepatic morbidities, a

self-reported high quality of life.

PMID: 15446316 [PubMed - in process]

[Guest guest]

Transplantation. 2004 Aug 27;78(4):566-73.

Health status ten years after pediatric liver transplantation--looking

beyond the graft.

Avitzur Y, De Luca E, Cantos M, Jimenez- C, N, Fecteau A, Grant

D, Ng VL.

Paediatric Academic Multi-Organ Transplantation (PAMOT) Program, Hospital

for Sick Children, University of Toronto, Toronto, Canada.

BACKGROUND: Little is known about long-term health after pediatric

orthotopic liver transplantation (OLT). This study aimed to characterize the

health status of recipients 10 years after OLT, with an emphasis on

transplant-related morbidity and quality of life. METHODS: We performed a

retrospective database review of 32 children who underwent OLT before

October 1992 at one center and were alive after 10 years. Outcome measures

were assessed 10 years after OLT. Cantril's self-anchoring scale was used

for global quality of life assessment. RESULTS: Synthetic liver function at

10 years was preserved in all patients. The annual rate of episodes of acute

rejection dropped markedly after the first year (1.4 at year 1 to 0.19

rejections/patient/year at year 10). Histologically confirmed chronic

rejection developed in eight (25%) patients. At 10 years, long-term

complications included mild to severe chronic renal failure (77%), mild

chronic anemia (59%), and hypertension (25%). Significant growth retardation

(z-score < -2), hyperlipidemia, and diabetes were uncommon. Infection

requiring hospitalization occurred in 81% of the patients, with varicella

zoster virus as the most common pathogen. Epstein-Barr virus-related

malignancies affected 22% of patients. Ten-year survivors perceived quality

of life as very good. Self-reporting of drug nonadherence by seven (22%)

adolescents may have contributed to development of late onset rejection in

this subgroup. Conclusions. Children who are 10-year survivors of OLT have

excellent graft function and, despite chronic extrahepatic morbidities, a

self-reported high quality of life.

PMID: 15446316 [PubMed - in process]

[Guest guest]

Transplantation. 2004 Aug 27;78(4):566-73.

Health status ten years after pediatric liver transplantation--looking

beyond the graft.

Avitzur Y, De Luca E, Cantos M, Jimenez- C, N, Fecteau A, Grant

D, Ng VL.

Paediatric Academic Multi-Organ Transplantation (PAMOT) Program, Hospital

for Sick Children, University of Toronto, Toronto, Canada.

BACKGROUND: Little is known about long-term health after pediatric

orthotopic liver transplantation (OLT). This study aimed to characterize the

health status of recipients 10 years after OLT, with an emphasis on

transplant-related morbidity and quality of life. METHODS: We performed a

retrospective database review of 32 children who underwent OLT before

October 1992 at one center and were alive after 10 years. Outcome measures

were assessed 10 years after OLT. Cantril's self-anchoring scale was used

for global quality of life assessment. RESULTS: Synthetic liver function at

10 years was preserved in all patients. The annual rate of episodes of acute

rejection dropped markedly after the first year (1.4 at year 1 to 0.19

rejections/patient/year at year 10). Histologically confirmed chronic

rejection developed in eight (25%) patients. At 10 years, long-term

complications included mild to severe chronic renal failure (77%), mild

chronic anemia (59%), and hypertension (25%). Significant growth retardation

(z-score < -2), hyperlipidemia, and diabetes were uncommon. Infection

requiring hospitalization occurred in 81% of the patients, with varicella

zoster virus as the most common pathogen. Epstein-Barr virus-related

malignancies affected 22% of patients. Ten-year survivors perceived quality

of life as very good. Self-reporting of drug nonadherence by seven (22%)

adolescents may have contributed to development of late onset rejection in

this subgroup. Conclusions. Children who are 10-year survivors of OLT have

excellent graft function and, despite chronic extrahepatic morbidities, a

self-reported high quality of life.

PMID: 15446316 [PubMed - in process]

[Guest guest]

Transplantation. 2004 Aug 27;78(4):566-73.

Health status ten years after pediatric liver transplantation--looking

beyond the graft.

Avitzur Y, De Luca E, Cantos M, Jimenez- C, N, Fecteau A, Grant

D, Ng VL.

Paediatric Academic Multi-Organ Transplantation (PAMOT) Program, Hospital

for Sick Children, University of Toronto, Toronto, Canada.

BACKGROUND: Little is known about long-term health after pediatric

orthotopic liver transplantation (OLT). This study aimed to characterize the

health status of recipients 10 years after OLT, with an emphasis on

transplant-related morbidity and quality of life. METHODS: We performed a

retrospective database review of 32 children who underwent OLT before

October 1992 at one center and were alive after 10 years. Outcome measures

were assessed 10 years after OLT. Cantril's self-anchoring scale was used

for global quality of life assessment. RESULTS: Synthetic liver function at

10 years was preserved in all patients. The annual rate of episodes of acute

rejection dropped markedly after the first year (1.4 at year 1 to 0.19

rejections/patient/year at year 10). Histologically confirmed chronic

rejection developed in eight (25%) patients. At 10 years, long-term

complications included mild to severe chronic renal failure (77%), mild

chronic anemia (59%), and hypertension (25%). Significant growth retardation

(z-score < -2), hyperlipidemia, and diabetes were uncommon. Infection

requiring hospitalization occurred in 81% of the patients, with varicella

zoster virus as the most common pathogen. Epstein-Barr virus-related

malignancies affected 22% of patients. Ten-year survivors perceived quality

of life as very good. Self-reporting of drug nonadherence by seven (22%)

adolescents may have contributed to development of late onset rejection in

this subgroup. Conclusions. Children who are 10-year survivors of OLT have

excellent graft function and, despite chronic extrahepatic morbidities, a

self-reported high quality of life.

PMID: 15446316 [PubMed - in process]