Long-term linear growth and puberty in pediatric liver transplant recipients

Mohammad, S.; Grimberg, A.; Rand, E.; Anand, R.; Yin, W.; Alonso, E. M.

J Pediatr. 2013 Aug 7; 163(5):1354-1360 e7

Abstract

OBJECTIVE: To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients. STUDY DESIGN: Review of data collected prospectively through the Studies of Pediatric Liver Transplantation registry. Thirty-one variables were tested as risk factors for linear growth impairment, and factors significant at P < .1 were included in a logistic regression model. Risk factor analysis was limited to 512 patients who had complete demographic and medical data. RESULTS: A total of 892 patients surviving their first liver transplant by >1 year, with >/=1 height recorded, who were between 8 and 18 years old between the years 2005 and 2009 were included. Median follow-up was 70.2 +/- 38.6 months, mean age was 12.9 +/- 3.3 years, and mean height z-score (zH) was -0.5 +/- 1.4 SD. Twenty percent had linear growth impairment at last follow-up. Of 353 subjects with Tanner stage data, 39% of girls and 42% of boys ages 16-18 years were not yet Tanner 5. Growth impairment rates were higher among boys than girls (30% vs 7%, P < .05) at Tanner stage 4, and occurred in 8/72 (11%) of Tanner 5 subjects. Among patients with parental height data, zH were lower than calculated mid-parental zH (P < .005). Independent predictors of growth impairment included linear growth impairment at transplant (OR 11.53, P

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