Long-Term Linear Growth and Puberty in Pediatric Liver Transplant Recipients
To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients. Review of data collected prospectively through the Studies of Pediatric Liver Transplantation registry. Thirty-one variables were tested as risk factors for linear growth impairm...
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| Published in | The Journal of pediatrics Vol. 163; no. 5; pp. 1354 - 1360.e7 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.11.2013
Mosby, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0022-3476 1097-6833 1097-6833 |
| DOI | 10.1016/j.jpeds.2013.06.039 |
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| Abstract | To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients.
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.
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 ≤ .0001), re-transplantation (OR 4.37, P = .001), non-white race (P = .0026), and primary diagnosis other than biliary atresia (P = .0105).
Linear growth impairment and delayed puberty are common in pubertal liver transplant recipients, with pre-transplant growth impairment identified as a potentially modifiable risk factor. Catch-up growth by the end of puberty may be incomplete. |
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| AbstractList | 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 ≤ .0001), re-transplantation (OR 4.37, P = .001), non-white race (P = .0026), and primary diagnosis other than biliary atresia (P = .0105). CONCLUSIONS: Linear growth impairment and delayed puberty are common in pubertal liver transplant recipients, with pre-transplant growth impairment identified as a potentially modifiable risk factor. Catch-up growth by the end of puberty may be incomplete. To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients. 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. 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 ≤ .0001), re-transplantation (OR 4.37, P = .001), non-white race (P = .0026), and primary diagnosis other than biliary atresia (P = .0105). Linear growth impairment and delayed puberty are common in pubertal liver transplant recipients, with pre-transplant growth impairment identified as a potentially modifiable risk factor. Catch-up growth by the end of puberty may be incomplete. To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients.OBJECTIVETo explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients.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.STUDY DESIGNReview 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.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 ≤ .0001), re-transplantation (OR 4.37, P = .001), non-white race (P = .0026), and primary diagnosis other than biliary atresia (P = .0105).RESULTSA 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 ≤ .0001), re-transplantation (OR 4.37, P = .001), non-white race (P = .0026), and primary diagnosis other than biliary atresia (P = .0105).Linear growth impairment and delayed puberty are common in pubertal liver transplant recipients, with pre-transplant growth impairment identified as a potentially modifiable risk factor. Catch-up growth by the end of puberty may be incomplete.CONCLUSIONSLinear growth impairment and delayed puberty are common in pubertal liver transplant recipients, with pre-transplant growth impairment identified as a potentially modifiable risk factor. Catch-up growth by the end of puberty may be incomplete. To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients. 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. 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 ≤ .0001), re-transplantation (OR 4.37, P = .001), non-white race (P = .0026), and primary diagnosis other than biliary atresia (P = .0105). Linear growth impairment and delayed puberty are common in pubertal liver transplant recipients, with pre-transplant growth impairment identified as a potentially modifiable risk factor. Catch-up growth by the end of puberty may be incomplete. |
| Author | Rand, Elizabeth Alonso, Estella M. Mohammad, Saeed Yin, Wanrong Anand, Ravinder Grimberg, Adda |
| AuthorAffiliation | 3 EMMES Corporation, Rockville, MD 2 Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 1 Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23916225$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_transproceed_2019_05_022 crossref_primary_10_1097_MOT_0000000000000116 crossref_primary_10_3390_nu13082785 crossref_primary_10_1111_petr_70014 crossref_primary_10_1002_lt_26339 crossref_primary_10_1111_petr_13989 crossref_primary_10_1139_apnm_2023_0033 crossref_primary_10_3389_frtra_2022_1042676 crossref_primary_10_1136_archdischild_2015_309580 crossref_primary_10_3389_fped_2023_1198360 crossref_primary_10_3390_medsci9020039 crossref_primary_10_1002_hep_32073 crossref_primary_10_1016_j_clinre_2014_08_005 crossref_primary_10_1016_j_jpedsurg_2014_09_010 crossref_primary_10_1097_MPG_0000000000001815 crossref_primary_10_1016_j_transproceed_2017_06_036 crossref_primary_10_1097_TP_0000000000004795 crossref_primary_10_1097_MOT_0000000000000165 crossref_primary_10_1177_0884533615600423 crossref_primary_10_1016_j_iliver_2022_08_003 crossref_primary_10_1186_s12887_022_03790_5 crossref_primary_10_1111_petr_13534 crossref_primary_10_1111_petr_14866 crossref_primary_10_1002_lt_25432 crossref_primary_10_1002_lt_24406 crossref_primary_10_1097_MPG_0000000000002443 |
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| Contributor | Millis, J Michael Fisher, Robert Tzakis, Andreas Lowell, Jeffrey Rosenthal, Phillip Lopez, James Bucuvalas, John Gilmour, Susan Karpen, Saul Alonso, Estella Gonzalez-Peralta, Regino Humar, Abhi Berquist, William Jonas, Maureen Tuttle-Newhall, Elizabeth Narkewicz, Michael Atkison, Paul Telega, Grzegorz Langnas, Alan Freese, Deborah Bozorgzadeh, Adel Lavine, Joel Horslen, Simon Martin, Steven Heffron, Thomas Halff, Glenn McDiarmid, Sue D'Alessandro, Anthony Tector, A Joseph Mittal, Naveen Fecteau, Annie Book, Linda Dunn, Stephen Mazariegos, George Kane, Robert Eason, James Lobritto, Steven Andrews, Walter Schwarz, Kathleen Kerkar, Nanda |
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| Copyright | 2013 Mosby, Inc. Mosby, Inc. Copyright © 2013 Mosby, Inc. All rights reserved. Copyright © 2013 Mosby Inc. All rights reserved. 2013 |
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| Snippet | To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients.
Review of data collected... Objective To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients. Study design Review of data... OBJECTIVE: To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients. STUDY DESIGN: Review of... To explore linear growth, puberty, and predictors of linear growth impairment among pubertal liver transplant recipients.OBJECTIVETo explore linear growth,... |
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| SubjectTerms | abnormal development Adolescent adverse effects boys Canada Child Cohort Studies compensatory growth diagnosis etiology Female Follow-Up Studies girls Growth Disorders Growth Disorders - diagnosis Growth Disorders - etiology Humans liver transplant Liver Transplantation Liver Transplantation - adverse effects Liver Transplantation - methods Male methods patients Pediatrics Puberty Registries Regression Analysis Risk Factors Time Factors Treatment Outcome United States |
| Title | Long-Term Linear Growth and Puberty in Pediatric Liver Transplant Recipients |
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