Low-dose steroids do make a difference: Independent risk factors for impaired linear growth after pediatric liver transplantation.
Adolescent
Body Height
/ drug effects
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Growth Disorders
/ etiology
Humans
Immunosuppressive Agents
/ administration & dosage
Infant
Infant, Newborn
Liver Transplantation
Logistic Models
Male
Postoperative Complications
/ etiology
Prednisolone
/ administration & dosage
Retrospective Studies
Risk Factors
Treatment Outcome
adverse events
complications of liver transplantation
development
failure to thrive
long-term results
steroid withdrawal
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
revised:
14
01
2021
received:
28
08
2020
accepted:
31
01
2021
pubmed:
11
3
2021
medline:
19
1
2022
entrez:
10
3
2021
Statut:
ppublish
Résumé
Growth failure persists after pediatric liver transplantation and impairs pediatric development and quality of life. Steroid dose minimization attempts to prevent growth impairment, yet long-term assessment in pediatric liver recipients is lacking. We identified risk factors for impaired linear growth after pediatric liver transplantation, with a special focus on low-dose steroid therapy. This is a single-center retrospective analysis of height development in pediatric liver recipients up to 5 years after transplantation. Risk factors for impaired linear growth (height Z-scores≤-2) at transplantation, after two (n = 347) and five years (n = 210) were identified by univariate and multivariate logistic regression. At transplantation, growth retardation was found in 52.2%, predominantly younger children. Height Z-scores improved from -2.23 to -1.40 (SE 0.11; 95%CI 0.74-1.16; p < .001) two years and -1.19 (SE 0.07;0.08-0.34; p = .017) five years post-transplant. Multivariate analysis showed previous growth impairment (OR=1.484; 95%-CI=1.107-1.988; p = .004), graft loss (49.006;2.232-1076; p = .006), and prolonged cold ischemic time (1.034;1.007-1.061; p = .011) as main long-term risk factors; steroid use was a significant predictor of 2-year but not 5-year growth impairment. In univariate analysis, impaired growth after 2 and 5 years was associated with continuous low-dose (2.5 mg/m
Substances chimiques
Immunosuppressive Agents
0
Prednisolone
9PHQ9Y1OLM
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13989Subventions
Organisme : German Federal Ministry of Education and Research
Informations de copyright
© 2021 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.
Références
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