Linear growth after pediatric liver transplantation

Bartosh, Sharon M.; Thomas, Susan E.; Sutton, Marjorie M.; Brady, Lynda; Whitington, Peter F.

doi:10.1016/s0022-3476(99)70062-4

Cited by 76 publications

(94 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, our data confirmed the greater effectiveness of intensive nutrition in shortening the length of hospital stay among females and younger patients, thus confirming the results of other studies (Renz et al, 2001;Bartosh, Thomas, Sutton, Brady, & Whitington;Saito et al, 2007). In some studies (Alonso, 2008;Bartosh et al, 1999;Saito et al, 2007), the mean height Z-score of the population waiting for liver transplantation ranged between -1.0 and -1.75.…”

Section: Discussionsupporting

confidence: 89%

“…He also emphasized the potential advantages of performing early liver transplantation during periods in which endocrinologic variables favor accelerated growth. Bartosh et al (1999), in contrast with Codoner-Franch et al (1994) believe that the best time to perform a transplant is not determined solely by age.…”

Section: Discussionmentioning

confidence: 99%

“…In some studies (Alonso, 2008;Bartosh et al, 1999;Saito et al, 2007), the mean height Z-score of the population waiting for liver transplantation ranged between -1.0 and -1.75. The mean height Z -score of the 34 children in our study, which was -1.30 ± 2.11 at admission, was within this range.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Therapeutic Effectiveness of Nutrition Therapy in Pediatric Patients with Chronic Liver Diseases Awaiting Liver Transplantation

Giammanco¹,

Bavetta²,

Greco³

et al. 2013

JFR

View full text Add to dashboard Cite

It is important to prevent protein/calorie malnutrition in children with end stage liver diseases prior to transplantation. This study involved 34 patients between the ages of 10 and 156 months (mean value 25.69 months  32.2) (13 females and 21 males) on the liver transplant waiting list. Data collected as of three months before transplant and up to ten months after the procedure concerned gender, age, weight, height, Pediatric End Stage Liver Disease Score, baseline pathology, type of nutrition, type of transplant, immunosuppression, pulse steroid therapy, length of stay, and post transplant complications. Linear regression analysis showed that the length of hospital stay was 24.5 days more for females than for males, but also that intensive nutrition therapy shortens this stay for both female patients (P = 0.085) and younger patients (P = 0.023). The study population was divided into two groups according to the different nutritional therapies adopted. The Student's t-test and Mann-Whitney test evidenced that the group receiving intensive nutrition therapy grew taller compared with the group following an oral diet (mean -1.37 and Prob = 0.043); that females grew taller compared to males (mean -1.65 +/-0.56); and that there was an increase in height among the children in the group receiving intensive nutrition therapy despite the presence (-1.37 +/-0.56) or absence (-14.8 +/-5.44 and Prob = 0.035) of complications, and despite the administration (-1.03 +/-0.33) or non administration (-1.48 +/-0.55 and Prob = 0.019) of steroids. Intensive nutrition therapy enhances the velocity of growth in height and shortens the length of hospital stay, thus optimizing the final prognosis of the baseline pathology.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Therapeutic Effectiveness of Nutrition Therapy in Pediatric Patients with Chronic Liver Diseases Awaiting Liver Transplantation

Giammanco¹,

Bavetta²,

Greco³

et al. 2013

JFR

View full text Add to dashboard Cite

show abstract

“…For example, in autoimmune hepatitis, primary biliary cirrhosis or primary sclerosing cholangitis it might be desirable to include steroids in the immunosuppressive protocol as a principle, though definitive and convincing data are not available; (2) given the very low rate of acute rejection episodes observed in the BAS-induced recipients, would it be possible to use a 'full' TAC monotherapy (31), or to delay or minimize TAC administration from the early post-transplant period in order to attempt to limit the long-term morbidity of calcineurin inhibitor administration? This could be of particular value in children with pretransplant nephrotoxicity, such as children undergoing liver retransplantation, those who have received chemotherapy for hepatoblastoma, or children with cystic fibrosis who have been exposed to multiple nephrotoxic antibiotics; (3) are IL-2 receptor antagonists the best induction therapy to be used to completely avoid steroids or to allow for delayed administration of calcineurin inhibitors? Polyclonal antibodies have been used as posttransplant induction therapy for more than two decades, but their use has been somewhat limited by their more severe side-effects and their association with a greater occurrence of cytokine release syndrome (32).…”

Section: Steroid-free Immunosuppression With Basiliximabmentioning

confidence: 99%

Randomized Trial of Basiliximab Induction versus Steroid Therapy in Pediatric Liver Allograft Recipients Under Tacrolimus Immunosuppression

Spada

Petz²,

Bertani

et al. 2006

American Journal of Transplantation

View full text Add to dashboard Cite

Avoidance of corticosteroids could be beneficial after pediatric liver transplantation (LTx). To test this hypothesis, we performed a randomized prospective study to compare immunosuppression with tacrolimus (TAC) and steroids versus TAC and basiliximab (BAS) after pediatric LTx. Seventy-two patients were recruited, 36 receiving TAC and steroids and 36 TAC and BAS. The primary endpoint was the occurrence of the first rejection episode. Secondary endpoints were the cumulative incidence and severity of rejection, patient and graft survival, and incidence of adverse events. Overall 1-year patient and graft survival rates were 91.4% and 85.5% in the steroid group, and 88.6% and 80% in the BAS group (p = NS). Patients free from rejection were 87.7% in the BAS group and 67.7% in the steroid group (p = 0.036). The use of BAS was associated with a 63.6% reduction in incidence of acute rejection episodes. Overall incidence of infection was 72.3% in the steroid group and 50% in the BAS group (p = 0.035). We conclude that the combination of TAC with BAS is an alternative to TAC and steroid immunosuppression in pediatric LTx, which allows for a significant reduction in the incidence of acute rejection and infectious complications.

show abstract

“…At this level of protein intake, children who have undergone OLT will achieve a BCAA intake (approxi- (36) and dietary intake is decreased (Ͻ1 g/kg/d), this population may need for therapeutic supplementation of the total BCAA. In summary, this study demonstrates that total BCAA requirements in children who have undergone OLT within the past 8 y are significantly lower than requirements in children with MCC liver disease, although requirements remain higher than those of healthy school-aged children (1,2).…”

Section: Discussionmentioning

confidence: 99%

Effect of Orthotopic Liver Transplantation (OLT) on Branched-Chain Amino Acid Requirement

et al. 2006

View full text Add to dashboard Cite

Little is known regarding the impact of liver transplantation on amino acid requirements in children. Since plasma levels of the branched-chain amino acids (BCAA) are decreased in the presence of normal levels of the aromatic amino acids after liver transplantation, normalization of hepatic function may not fully correct changes in BCAA metabolism that occur in the pretransplant period. The goal of the present study was to determine total BCAA requirements of children following liver transplantation. The requirement of total BCAA was determined using indicator amino acid oxidation (IAAO) in five clinically stable children (5.7 Ϯ 3.5 y, mean Ϯ SD) 1-8 y post liver transplantation. Children received in random order 6 graded intakes of total BCAA. Individual BCAA in the test diet were provided in the same proportions as present in egg protein to minimize the potential interactive effects of individual BCAA on assessment of requirement. Total BCAA requirement was determined by measuring the oxidation of L-[1-13 C] phenylalanine to 13 CO 2 [F 13 CO 2 in mol/kg/h], after a primed, continuous infusion of the tracer and using a two-phase linear regression crossover regression analysis. The estimated average requirement and the upper limit of the 95% CI for total BCAA in children who have undergone liver transplantation were 172 and 206 mg/kg/d), respectively. Total BCAA requirement in children who have undergone orthotopic liver transplantation (OLT) remain increased in the post-liver transplant period when compared with healthy school aged children, but is decreased when compared with children with mild-moderate chronic cholestatic ( T here is no previous information regarding BCAA requirements in children who have undergone OLT. We have shown previously that total BCAA requirements in children with MCC liver disease are higher than requirements in healthy school-aged children (1,2) This increase in total BCAA requirement was observed in a population of children with a similar body composition, age, growth, and nutritional status as healthy school-aged children studied previously (2). The only major difference was that the children with MCC liver disease had decreased plasma concentrations of the BCAA in the presence of increased requirements for the total BCAA, suggesting that changes in plasma BCAA levels may be reflective of differences in BCAA requirement in this population (1,2). In children, there is little information regarding the impact of OLT on BCAA metabolism. However there is evidence that plasma concentrations of the BCAA remain depressed after OLT, whereas aromatic amino acid concentrations are usually normal, suggesting that BCAA requirements may be increased post-OLT (3-5).There is limited information regarding the potential mechanism responsible for a change in plasma BCAA concentrations after OLT. Normal concentrations of the AAA in the posttransplant period suggest that hepatic metabolism of the AAA have normalized, whereas depressed levels of the BCAA point to the skeletal muscle as the s...

show abstract

Linear growth after pediatric liver transplantation

Cited by 76 publications

References 40 publications

Therapeutic Effectiveness of Nutrition Therapy in Pediatric Patients with Chronic Liver Diseases Awaiting Liver Transplantation

Therapeutic Effectiveness of Nutrition Therapy in Pediatric Patients with Chronic Liver Diseases Awaiting Liver Transplantation

Randomized Trial of Basiliximab Induction versus Steroid Therapy in Pediatric Liver Allograft Recipients Under Tacrolimus Immunosuppression

Effect of Orthotopic Liver Transplantation (OLT) on Branched-Chain Amino Acid Requirement

Contact Info

Product

Resources

About