Post-transplant hepatic fibrosis in pediatric liver-small bowel transplant recipients: A single-center, retrospective, observational study

Hanh D. Vo, Stanley J Radio, Emille M. Reyes-Santiago, Teri J Mauch

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Little is known about the prevalence of hepatic graft fibrosis in combined LSBT children. We aimed to determine the prevalence of and identify potential predictors for hepatic graft fibrosis in LSBT children and to compare them with those in LT children. Methods: We retrospectively included children younger than 19 years who had received a primary LT/LSBT between 2000 and 2018 and had a liver biopsy performed at least 6 months post-transplant. A Cox proportional hazards regression model was used to determine predictors associated with significant hepatic graft fibrosis (≥F2) in LSBT vs LT children. Results: Ninety-six children (47 LSBT, 54 females) were included. The median post-transplant follow-up (years) was 12.8 in LT vs 10.5 in LSBT patients (P =.06). Hepatic graft fibrosis was found in 81.6% of LT vs 70.2% of LSBT children (P =.19), after a median time of 2.5 years and 2.6 years, respectively. On multivariate analyses, having post-transplant biliary complications was found to be associated with significant graft fibrosis in LT children, whereas AST/ALT ratio was found to predict significant hepatic graft fibrosis in LSBT children. The use of parenteral nutrition after transplant was not associated with significant hepatic graft fibrosis. Conclusions: The prevalence of hepatic graft fibrosis in LSBT children did not significantly differ from that in LT children, but the predictors may differ. Future studies should investigate the role of post-transplant autoimmune antibodies and donor-specific antibodies in the development and progression of hepatic graft fibrosis in LSBT children.

Original languageEnglish (US)
JournalPediatric Transplantation
DOIs
StateAccepted/In press - 2020

Keywords

  • children
  • hepatic graft fibrosis
  • liver fibrosis
  • liver transplant
  • liver-small bowel transplant
  • predictor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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