Living related liver transplantation impact on nutritional status of children with chronic liver disease

ABSTRACT

Chronic liver diseases in infants and children are often associated with poor growth, protein calorie malnutrition and vitamin deficiencies. Although liver transplantation [LTx] has become standard therapy for end stage liver disease in children, growth after living related liver transplantation [LRLT] remains an area of concern, and the present study tries to elucidate this issue. The children included in this study classified into Transplant group [Group 1], Awaiting group [Group 2] and Control group [Group 3]. Those patients were assessed by thorough history, anthropometrical measures and complete clinical examination. Also assessed for post transplant infections, graft dysfunction and immunosuppressive regimen. Food intake was registered [24 hour recall] and caloric requirement was calculated according to the Egyptian food composition table. The mean height, weight, [MAC] and caloric intake were significantly lower in the pre transplant cases when compared to the post transplant. The Z-score in the 8 patients included in the transplant group show improvement in height, weight, MAC and caloric intake. The mean height, weight, MAC and caloric intake in the awaiting group were lower after one year follow up than during the preparation for transplant. The Z-score in the 15 patients included in the awaiting group show shift to the more negative side in height, weight, MAC and caloric intake. The mean levels of albumin, Fe, Zn and Se were elevated significantly in the post transplant group when compared to the pre-transplant cases. The mean levels of albumin, Fe, Zn and Se were low in the awaiting group when compared to the control group. Persistent growth failure post transplantation is multifactorial and is related to the preoperative malnutrition, feeding problems and post operative complications. Liver diseases may compromise growth and nutritional status. An improvement occurred in many parameters of growth and nutritional status after LRLT especially MAC and caloric intake