Linear Growth Predicts Acute Post-Transplant Outcomes in Paediatric Liver Transplant Patients

Jillian S Owens

doi:10.23937/2469-5769/1510019

Abstract

Minimal research has been conducted on the effect of nutritional status on acute post-transplant outcomes in pediatric liver transplant patients. The purpose of this study was to determine the effect of pre-transplant nutritional status (height, weight, albumin, hemoglobin, Vitamin A, Vitamin E, Vitamin D, mean corpuscular volume (MCV), calcium, magnesium and phosphorus) on acute post-transplant outcomes (length of hospital stay and infection rate).

Highlights

Chronic liver disease is associated with poor nutritional status in children if cholestasis is longstanding and the onset is in infancy [1,2]
The results of the ANOVA showed no differences in outcome based on diagnosis all groups were collapsed for future analysis
The results for the entire cohort of patients in the current study show that poor linear growth even -1.5 standard deviations (SD) below the population mean had a significant negative effect on length of hospital stay post liver transplantation but that the negative effects of poor linear growth on susceptibility to infections manifest itself at higher growth deficits i.e. ≤ -2.5 SD below the mean

Summary

Introduction

Chronic liver disease is associated with poor nutritional status in children if cholestasis is longstanding and the onset is in infancy [1,2]. Eighty percent of adults with ESLD requiring transplantation are considered malnourished [11,12]. This results in increased morbidity and mortality [12] longer length of stay in the intensive care unit (ICU) as well as a longer overall length of hospital stay [13]. In children, those who are malnourished pre-transplant have higher infections rates, more surgical complications, and higher mortality compared to those that are better nourished [14,15]. Children with height z-scores -1.5 with an increased hospital cost of $40,000 average per child [10]

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Conclusion