Long Term Outcomes after Pediatric Liver Transplantation
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Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers address-ing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life pro-ductivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle.
Abstract
Long term outcomes after liver transplantation are major determinants of quality of life and of the value of this heroic treatment. As short term outcomes are excellent, our community is turning to take a harder look at long term outcomes. The purpose of this paper is to review these outcomes, and highlight proposed treatments, as well as pressing topics needing to be studied. A systemic review of the English literature was carried in PubMed, covering all papers address-ing long term outcomes in pediatric liver transplant from 2000-2013. Late outcomes after pediatric liver transplant affect the liver graft in the form of chronic liver dysfunction. The causes include rejection particularly humoral rejection, but also de novo autoimmune hepatitis, and recurrent disease. The metabolic syndrome is a major factor in long term cardiovascular complication risk. Secondary infections, kidney dysfunction and malignancy remain a reality of those patients. There is growing evidence of late cognitive and executive function delays affecting daily life pro-ductivity as well as likely adherence. Finally, despite a good health status, quality of life measures are comparable to those of children with chronic diseases. Long term outcomes are the new frontier in pediatric liver transplantation. Much is needed to improve graft survival, but also to avoid systemic morbidities from long term immunosuppression. Quality of life is a new inclusive measure that will require interventions and innovative approaches respectful not only on the patients but also of their social circle.
참고문헌 (38)
- Ng VL, "Studies of Pediatric Liver Transplantation (SPLIT) Research Group. Health status of children alive 10 years after pediatric liver transplantation performed in the US and Canada: report of the studies of pediatric liver transplantation experience", J Pediatr, 160, pp.820~826 (2012)
- Kelly DA, "Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation", Liver Transpl, 19, pp.798~825 (2013)
- Bekker J, "Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors", Am J Transplant, 9, pp.746~757 (2009)
- Jensen MK, "Management and long-term consequences of portal vein thrombosis after liver transplantation in children", Liver Transpl, 19, pp.315~321 (2013)
- Mazariegos GV, "Withdrawal of immunosuppression in liver transplantation: lessons learned from PTLD", Pediatr Transplant, 8, pp.210~213 (2004)
- Kaneku H, "De novo donorspecific HLA antibodies decrease patient and graft survival in liver transplant recipients", Am J Transplant, 13, pp.1541~1548 (2013)
- Evans HM, "Progressive histological damage in liver allografts following pediatric liver transplantation", Hepatology, 43, pp.1109~1117 (2006)
- Ekong UD, "Graft histology characteristics in long-term survivors of pediatric liver transplantation", Liver Transpl, 14, pp.1582~1587 (2008)
- Scheenstra R, "Graft fibrosis after pediatric liver transplantation: ten years of follow-up", Hepatology, 49, pp.880~886 (2009)
- Liberal R, "Liver transplantation and autoimmune liver diseases", Liver Transpl, 19, pp.1065~1077 (2013)
- Desai M, "Chronic liver allograft dysfunction", Transplant Proc, 41, pp.773~776 (2009)
- Martin SR, "SPLIT Research Group. Outcomes in children who underwent transplantation for autoimmune hepatitis", Liver Transpl, 17, pp.393~401 (2011)
- Aguilera I, "Complement component 4d immunostaining in liver allografts of patients with de novo immune hepatitis", Liver Transpl, 17, pp.779~788 (2011)
- Gibelli NE, "Sirolimus in pediatric liver transplantation: a single-center experience", Transplant Proc, 41, pp.901~903 (2009)
- Sutedja DS, "Revealing the cause of cryptogenic cirrhosis by posttransplant liver biopsy", Transplant Proc, 36, pp.2334~2337 (2004)
- Campbell K, "SPLIT Renal Function Working Group. Glomerular filtration rate following pediatric liver transplantation--the SPLIT experience", Am J Transplant, 10, pp.2673~2682 (2010)
- Nobili V, "Pediatric post-transplant metabolic syndrome: new clouds on the horizon", Pediatr Transplant, 17, pp.216~223 (2013)
- Ng VL, "Studies of Pediatric Liver Transplantation Research Group. Outcomes of 5-year survivors of pediatric liver transplantation: report on 461 children from a north american multicenter registry", Pediatrics, 122, pp.e1128~1135 (2008)
- Madhwal S, "Is liver transplantation a risk factor for cardiovascular disease? A meta-analysis of observational studies", Liver Transpl, 18, pp.1140~1146 (2012)
- Centers for Disease Control and Prevention (CDC), "Advisory Committee on Immunization Practices (ACIP) recommended immunization schedule for persons aged 0 through 18 years - United States, 2013", MMWR Surveill Summ, 62(1), pp.1~ (2013)
- Codoner-Franch P, "Long-term follow-up of growth in height after successful liver transplantation", J Pediatr, 124, pp.368~373 (1994)
- Sebagh M, "Twenty-year protocol liver biopsies: Invasive but useful for the management of liver recipients", J Hepatol, 56, pp.840~847 (2012)
- Heffron TG, "Pediatric liver transplantation for acute liver failure at a single center: a 10-yr experience", Pediatr Transplant, 14, pp.228~232 (2010)
- Lao OB, "Identifying the futile pediatric liver re-transplant in the PELD era", Pediatr Transplant, 14, pp.1019~1029 (2010)
- Feng S, "Complete immunosuppression withdrawal and subsequent allograft function among pediatric recipients of parental living donor liver transplants", JAMA, 307, pp.283~293 (2012)
- Bohne F, "Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation", J Clin Invest, 122, pp.368~382 (2012)
- Tryphonopoulos P, "Long-term follow-up of 23 operational tolerant liver transplant recipients", Transplantation, 90, pp.1556~1561 (2010)
- Abdelmalek MF, "Sirolimus Liver Conversion Trial Study Group. Sirolimus conversion regimen versus continued calcineurin inhibitors in liver allograft recipients: a randomized trial", Am J Transplant, 12, pp.694~705 (2012)
- Berquist RK, "Adolescent non-adherence: prevalence and consequences in liver transplant recipients", Pediatr Transplant, 10, pp.304~310 (2006)
- Shemesh E, "A pilot study of posttraumatic stress and nonadherence in pediatric liver transplant recipients", Pediatrics, 105, pp.E29~ (2000)
- Shemesh E, "Adherence to medical recommendations and transition to adult services in pediatric transplant recipients", Curr Opin Organ Transplant, 15, pp.288~292 (2010)
- Pollock-Barziv SM, "Variability in tacrolimus blood levels increases the risk of late rejection and graft loss after solid organ transplantation in older children", Pediatr Transplant, 14, pp.968~975 (2010)
- Fredericks EM, "Assessment of transition readiness skills and adherence in pediatric liver transplant recipients", Pediatr Transplant, 14, pp.944~953 (2010)
- Huda A, "High rate of unemployment after liver transplantation: analysis of the United Network for Organ Sharing database", Liver Transpl, 18, pp.89~99 (2012)
- Burra P, "Adherence in liver transplant recipients", Liver Transpl, 17, pp.760~770 (2011)
- Limbers CA, "Studies of Pediatric Liver Transplantation Functional Outcomes Group. Healthrelated quality of life in pediatric liver transplant recipients compared with other chronic disease groups", Pediatr Transplant, 15, pp.245~253 (2011)
- Mohammad S, "Health status in young adults two decades after pediatric liver transplantation", Am J Transplant, 12, pp.1486~1495 (2012)
- Sorensen LG, "Studies of Pediatric Liver Transplantation (SPLIT) and Functional Outcomes Group (FOG). Cognitive and academic outcomes after pediatric liver transplantation: Functional Outcomes Group (FOG) results", Am J Transplant, 11, pp.303~311 (2011)