Abstract
Aims: to study the growth of children with liver disease before and after LT.Methods: longitudinal study (LS): 16 infants (9 M. 7 F); age 0.73 to 2.38 years (X 1.39) at LT; mean height (Ht) SDS at LT: −2.02 (SD 1.25). Post-LT medication: cyclosporine in tapering doses; prednisone, by daily regimen (DP) for the first 6-12 months, with tapering doses depending on clinical course, then on alternate day regimen (ADP). Cross-sectional study (CSS): 95 children (55 M. 40 F) aged 0.17 to 14.88 (X 3.83), observed before LT, after LT on DP, and on ADP (same medication).Results: LS: pre-LT height velocity (HV) SDS (x±SD −0.60±1.31) significantly lower (p<0.01) than ADP-HVSDS (2.84±1.59) but not significantly different from DP-HVSDS (−1.37±1.66). CSS: DP-HtSDS (X±SD −1.9±1.32) significantly lower (p<0.01) than pre-LT-HtSDS (−1.07±1.06) and ADP-HtSDS (−0.98±1.23). Similar results for sitting height (SH) SDS and subischial leg length (SLL) SDS: pre-LT and ADP-SLLSDS significantly greater than pre-LT and ADP-SHSDS (p=0.01); DP-SLLSDS not significantly different from DP-SHSDS. Significant improvement of head circumpherencc SDS and skinfold SDS on ADP.Conclusions: growth in children with liver disease does not improve after LT on DP while shows catch-up growth on ADP; therefore, it mainly depends on clinical course and cortieosteroid regimen.
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