Long-Term Follow-up after Pediatric Liver Transplantation: Predictors of Growth.

Objectives: To describe long-term growth post-pediatric liver transplantation and to conduct bivariate and multivariate analysis of factors that may predict post-transplantation growth in children who received a liver transplant from January 1999 to December 2008 at the Hospital for Sick Children. Methods: A retrospective cohort study was conducted with follow-up of up-to 10 years post-transplantation. Mean height and weight z-scores and annual differences in mean z-scores were plotted against time after transplantation. A one-way ANOVA was conducted. Multivariate and Univariate Cox proportional hazards analyses were conducted to determine factors associated with reaching the 50th and 25th percentiles for height. Results: A total of 127 children met eligibility criteria. The mean height z-score at time of transplantation was -2.21 which by the second year post-transplantation increased significantly to -0.66 (mean increase of 1.55 standard deviation units). There were no further significant increases in mean height z-score from two years post-transplantation until the end of follow-up at year 10. In multivariate analysis, height at transplant was the most important predictor of linear growth post-transplantation. Conclusion: Children who underwent liver transplantation had significant catch-up growth in the first 2 years post-transplantation followed by a plateau phase. Increased height z-score at transplantation is the most important predictor of long-term growth. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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