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Review
. 2013 Dec;16(4):207-18.
doi: 10.5223/pghn.2013.16.4.207. Epub 2013 Dec 31.

Long term outcomes after pediatric liver transplantation

Nada A Yazigi  1
Affiliations
Review

Long term outcomes after pediatric liver transplantation

Nada A Yazigi. Pediatr Gastroenterol Hepatol Nutr. 2013 Dec.

Abstract

Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers addressing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life productivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle.

Keywords: Children; Liver; Patients outcome; Transplants.

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Figures

Fig. 1
Fig. 1
The vulnerable population model: chronic life-long disease with both controllable and un-controllable elements.
See this image and copyright information in PMC

References

    1. Ng VL, Alonso EM, Bucuvalas JC, Cohen G, Limbers CA, Varni JW, et al. Studies of Pediatric Liver Transplantation (SPLIT) Research Group. Health status of children alive 10 years after pediatric liver transplantation performed in the US and Canada: report of the studies of pediatric liver transplantation experience. J Pediatr. 2012;160:820–826. - PMC - PubMed
    1. Kelly DA, Bucuvalas JC, Alonso EM, Karpen SJ, Allen U, Green M, et al. Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver Transpl. 2013;19:798–825. - PubMed
    1. Bekker J, Ploem S, de Jong KP. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Am J Transplant. 2009;9:746–757. - PubMed
    1. Jensen MK, Campbell KM, Alonso MH, Nathan JD, Ryckman FC, Tiao GM. Management and long-term consequences of portal vein thrombosis after liver transplantation in children. Liver Transpl. 2013;19:315–321. - PubMed
    1. Mazariegos GV. Withdrawal of immunosuppression in liver transplantation: lessons learned from PTLD. Pediatr Transplant. 2004;8:210–213. - PubMed