Department of Pediatrics, Cairo University, Cairo, Egypt.
Department of Radiology, Cairo University, Cairo, Egypt.
Medicine (Baltimore). 2022 Nov 11;101(45):e31156. doi: 10.1097/MD.0000000000031156.
Liver transplantation (LT) is the definitive treatment of end-stage liver disease. The long-term survival following LT spurred more interest in improving the quality of life of patients. This was a cohort study that included 23 pediatric liver transplant recipients who underwent LT due to hereditary or metabolic liver diseases. Bone health assessment was performed at their last follow up clinically (anthropometric measures), biochemically and radiologically (Dual Energy X-ray Absorptiometry [DEXA] scans). Poor bone health was defined as z-score <-1. Mean age at LT was 5.77 years (standard deviation [SD] 3.64) and 43% were males. Biliary atresia was the most common cause of end stage liver disease (35%). Mean age at follow up was 14 years (SD 5.48) and mean follow up was 8 years (SD 4.12 years). Eleven patients (48%) had poor bone health (osteopenia 22% and osteoporosis 26%). On univariate analysis, being on steroids at last follow up (odds ratio [OR] 13.2, 95% confidence interval [CI] 1.23-140.67, P = .03), weight at last follow up (OR 0.45, 95% CI 0.20-0.99, P = .04), platelets at last follow up (OR 0.98, 95% CI 0.96-s0.99, P = .02), hemoglobin at last follow up (OR 0.33, 95% CI 0.12-0.89, P = .03) were significantly associated with poor bone health. None of the variables were significant on multivariate analysis. At most recent follow up, 48% of patients demonstrated poor bone health by DEXA scans. More studies are required to evaluate predictors of poor bone health after LT in children.
肝移植（LT）是治疗终末期肝病的确定性方法。LT 后长期存活激发了人们对提高患者生活质量的更多兴趣。这是一项队列研究，纳入了 23 名因遗传性或代谢性肝病而接受 LT 的儿科肝移植受者。在最后一次临床随访时（人体测量指标）、生化指标和影像学检查（双能 X 线吸收仪 [DEXA] 扫描）进行骨骼健康评估。骨健康不良定义为 z 评分 <-1。LT 时的平均年龄为 5.77 岁（标准差 [SD] 3.64），43%为男性。胆道闭锁是导致终末期肝病的最常见原因（35%）。随访时的平均年龄为 14 岁（SD 5.48），平均随访时间为 8 年（SD 4.12 年）。11 名患者（48%）骨健康不良（骨质疏松症 22%，骨质疏松症 26%）。单因素分析显示，最后一次随访时服用类固醇（比值比 [OR] 13.2，95%置信区间 [CI] 1.23-140.67，P=0.03）、最后一次随访时体重（OR 0.45，95%CI 0.20-0.99，P=0.04）、最后一次随访时血小板（OR 0.98，95%CI 0.96-0.99，P=0.02）、最后一次随访时血红蛋白（OR 0.33，95%CI 0.12-0.89，P=0.03）与骨健康不良显著相关。多因素分析中无变量具有统计学意义。在最近一次随访中，48%的患者通过 DEXA 扫描显示骨健康不良。需要进一步研究来评估儿童 LT 后骨健康不良的预测因素。
