Complications in paediatric liver transplant from Kuwait when transplanted abroad

Since the introduction of liver transplantation [LTx] in children suffering from liver failure in 1963, many centres around the world have offered this service to children that have no other alternative. The aim of this retrospective study is to analyse the results of paediatric liver transplant in Kuwait over the last decade. A retrospective chart review was done involving paediatric patients during the time period of 1995-2004. The information collected included patient demographics, indications for liver transplantation, survival of both patient and allograft, and complications. A total of 16 cases were found and analysed. The mean age was 3.6 years [ranged 5 months-17 years]. There were nine boys and seven girls. The most common indications for LTx were biliary atresia and metabolic liver disease. All the liver transplants were done abroad. There were totally nine deceased donor and seven living related cases. The complications were acute cellular rejection in five, hypertension in two, biliary complications in four, cytomegalovirus [CMV] infection in three and post lymphoprolifer-ative disease in two cases. All but one patient are presently alive. The above information demonstrates that LTx in Kuwati children is safe and improves the quality of life for those that would otherwise have no other alternative

Epidemiology and outcome of severe hepatitis A infection in children in Kuwait

To describe the epidemiology, clinical features and outcome of hepatitis A virus [HAV] infection in children in Kuwait. The medical records of 350 patients [age 0-16 years] admitted to the Infectious Diseases Hospital, Kuwait, between January 2000 and December 2002, with hepatitis A infection were reviewed. The mean age was 8.6 +/- 3.8 years and 47% of patients were between 7 and 12 years old. Kuwaiti children comprised 44% of admitted patients. The largest proportion of children with hepatitis A [34%] were from the northern part of the country. HAV infection was prevalent throughout the year with a peak during the months of August to October. Of the Kuwaiti children, 31% reported a history of contact with jaundiced patients, while 52% of the non-Kuwaiti children had a history of recent travel prior to their illness. Patients had symptoms for a mean of 6 +/- 3.6 days prior to presentation. The mean length of hospitalization was 5.8 +/- 2.9 days. The rate of complications of HAV infection was 6% and only one child required admission to the intensive care unit for fulminant hepatitis. None of the patients had permanent sequelae. HAV infection is a significant cause of morbidity for children in Kuwait. The disease is mostly prevalent in preschool and school age children. Despite the excellent outcome of all patients, a considerable number of patients tend to have a complicated course and prolonged hospitalization. In view of these data, hepatitis A vaccine should be considered as a part of routine childhood immunization in Kuwait

Ossicular damages in chronic suppurative ear disease

Ossicular damage is a frequently encountered sequel of chronic suppurative otitis media. It is associated with both chloesteatomous and non cholesteatomous pathologies. In this series of 100 cases, who underwent exploration of tympanomastoid region, 67 cases showed various froms of ossicular damages. We found multiossicular losses to be more frequent than isolated involvement of a single ossicle. Granulations were more frequent [49%] than cholesteatoma [15%]. Central defects of the tympanic membrane dominated