Hepatic and Cardiac Function Assessment in Children following Liver Transplantation
Salwa Amin Abd El-Hamid;
Abstract
ABSTRACT
Background: Since survival rate after pediatric liver transplantation has improved, the focus of interest has shifted to gradually evolving histological changes. Acute cellular rejection or chronic rejection as well as immunosuppressive drug-induced hepatic injury are critical causes of abnormal graft function and histology.
Aim of the work: This study aims to evaluate hepatic function and histology in children after liver transplantation.
Subjects and Methods: The current study was conducted on twenty patients who underwent liver transplantation 1year-12year ago. All subjects included in this study were recruited from specialized Hepatology clinic at Ain Shams University hospital and Dr Yassin Abd El Ghaffar Charity Center for Liver Disease and Research, Cairo, Egypt . Patients were subjected to full history taking, complete physical examination ,laboratory investigations and liver biopsy.
Results: The results showed that fibrosis is prevalent in 25%. There was no relation between fibrosis and recipient age, donor age at transplantation, donor recipient age ratio or post surgical biliary and vascular complication. Acute rejection was diagnosed in 45% of the biopsies and chronic rejection was in 35% of our patients. Normal histology was in 15% of our patients. Acute rejection had positive significant relation with ALT level at time of biopsy (P value=0.049). Chronic rejection had significant relation with sex mismatching between donor & recipient (P value=0.032).
Conclusion: Rejection and fibrosis are common findings in transplanted liver biopsy in pediatrics. Age of donor, recipient at transplantation, mean age difference between them or CMV infection are not risk factors for development of rejection or fibrosis. Donor recipient sex mismatching is a risk factor for chronic rejection. Liver function does not seem to be influenced by development of fibrosis or chronic rejection. However, ALT is influenced by acute rejection.
Key Words: Liver Transplantation, Fibrosis, rejection
Background: Since survival rate after pediatric liver transplantation has improved, the focus of interest has shifted to gradually evolving histological changes. Acute cellular rejection or chronic rejection as well as immunosuppressive drug-induced hepatic injury are critical causes of abnormal graft function and histology.
Aim of the work: This study aims to evaluate hepatic function and histology in children after liver transplantation.
Subjects and Methods: The current study was conducted on twenty patients who underwent liver transplantation 1year-12year ago. All subjects included in this study were recruited from specialized Hepatology clinic at Ain Shams University hospital and Dr Yassin Abd El Ghaffar Charity Center for Liver Disease and Research, Cairo, Egypt . Patients were subjected to full history taking, complete physical examination ,laboratory investigations and liver biopsy.
Results: The results showed that fibrosis is prevalent in 25%. There was no relation between fibrosis and recipient age, donor age at transplantation, donor recipient age ratio or post surgical biliary and vascular complication. Acute rejection was diagnosed in 45% of the biopsies and chronic rejection was in 35% of our patients. Normal histology was in 15% of our patients. Acute rejection had positive significant relation with ALT level at time of biopsy (P value=0.049). Chronic rejection had significant relation with sex mismatching between donor & recipient (P value=0.032).
Conclusion: Rejection and fibrosis are common findings in transplanted liver biopsy in pediatrics. Age of donor, recipient at transplantation, mean age difference between them or CMV infection are not risk factors for development of rejection or fibrosis. Donor recipient sex mismatching is a risk factor for chronic rejection. Liver function does not seem to be influenced by development of fibrosis or chronic rejection. However, ALT is influenced by acute rejection.
Key Words: Liver Transplantation, Fibrosis, rejection
Other data
| Title | Hepatic and Cardiac Function Assessment in Children following Liver Transplantation | Authors | Salwa Amin Abd El-Hamid | Issue Date | 2018 |
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