Cholelithiasis in pediatric organ transplantation: Detection and management

Abstract

The real incidence and the underlying causes of cholelithiasis in pediatric solid organ recipients is probably not exactly known. In addition to well-established risk factors for cholelithiasis, children after heart, kidney, or liver transplantation may develop gallstones due to drug therapy, sepsis, parenteral nutrition, or surgical complications. For pediatric patients, data are very limited and heterogeneous. However, the incidence in pediatric heart recipients seems to be substantially higher compared with kidney or liver graft recipients. In this review article the present data are discussed focusing on incidence, detection, and management of cholelithiasis in pediatric organ transplantation. In general, surgery is the therapy of choice in symptomatic patients; however, the pharmacological profile of ursodeoxycholic acid and the first results on its clinical impact are promising. The value of prophylactic therapy with ursodeoxycholic acid must be determined in further studies.

Management of Gallstones in the Pediatric Patient

“…This increase may be related to drug therapy (ceftriaxone, cyclosporine A, octreotide, and clofi brate), sepsis, parenteral nutrition, or surgical complications [ 83 ]. Hoffmeister et al [ 84 ] followed 1,325 patients who underwent hematopoietic stem cell transplant in childhood and were followed for 40 years.…”