ArticleEClinicalMedicine2021
Outcomes of adults who received liver transplant as young children.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 34 citations in OpenAlex.
- Ductular Reaction Underlies Development of Portal Hypertension in Biliary Atresia.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Psychological Burden and Quality of Life After Pediatric Liver Transplantation: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- From graft survival to life: redefining success after pediatric liver transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2026Review
- Prognostic Outcomes by Ishak Fibrosis Score Grouping in Biliary Atresia After Kasai Surgery.International journal of general medicine · 2026Article
- Article
- Association of Functional, Academic, Motor, and Cognitive Deficits in Graft Failure in Pediatric Liver Transplantation.Clinical transplantation · 2025Article
- Management of hepatocellular carcinoma in elderly and adolescent/young adult populations.Journal of liver cancer · 2025Article
- Avoidant Restrictive Food Intake Disorder in Pediatric Liver Transplant Patients.Pediatric transplantation · 2025Article
- Cognitive function of children with biliary atresia after primary living donor liver transplantation.BMC pediatrics · 2024Article
- Pediatric Liver Transplantation: Selection Criteria and Post-transplant Medical Management.Indian journal of pediatrics · 2024Review
- Cellular Therapies in Pediatric Liver Diseases.Cells · 2022Review
- Liver Transplantation for Tyrosinemia Type 1 in the Developing World: Is It Really the Best We Can Offer?Indian journal of pediatrics · 2022Article
- Variability of Care and Access to Transplantation for Children with Biliary Atresia Who Need a Liver Replacement.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatient and graft survival 20-years after pediatric liver transplantation (pLT) are excellent. In children, attainment of normal growth, education and social adaptation to be an independent adult are equally important. This is particularly relevant for children who receive liver transplant at a young age, where infantile-onset liver disease, surgery and immunosuppression can adversely affect growth and neurodevelopment. The aim of this study was to evaluate the long-term physical and psychosocial outcomes of pLT recipients with normal graft function. We coin the term 'meaningful survival'.
methodsWe performed a cross-sectional study of pLT recipients who received transplants between 1985 and 2004. A 20-year evaluation of physical health (growth, renal function), mental wellbeing and social outcomes (substance abuse, adherence, education, employment) was performed. All patients included were considered to have normal graft function.
findingsEighty-four patients met study criteria. Median age at transplantation was 1.3 years (IQR 0·7-3·3 years), with median duration of follow-up of 20.2 years (18·0-23·5). At median of 20-years, 19 patients (23%) had chronic renal dysfunction and 3 patients (4%) had a BMI of >30 (mean 20·4). Evaluation of long-term psychosocial outcomes demonstrated 22 patients (26%) with mental health disorders. Substance abuse was lower than national average. 62 patients (74%) were in education, employment or training. Overall, only 26% of our cohort achieved a composite outcome of 'meaningful survival'.
interpretationThis is the largest reported long-term study of biopsychosocial outcomes of pLT recipients with normal liver biochemistry, with follow-up upon completion of physical growth and senior school education. Importantly, despite normal liver function, many patients did not demonstrate 'meaningful survival'. We must refocus our efforts towards better understanding the long-term outcomes of children. A 'meaningful survival' rather than mere survival should be our goal.
fundingNone.
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