Long-term follow-up of growth in height after successful liver transplantation.

Quantitative assessment of growth in height during the long-term follow-up of children who underwent orthotopic liver transplantation was done to allay concerns related to the progress of the children in terms of normal relationships with peers. Height curves were constructed for 119 children who received transplants at Bicêtre and Cochin Hospitals and were followed for more than 1 year. Poor linear growth was observed during the first 6 months after transplantation, during which time children received corticosteroids daily. The onset of catch-up growth was observed between 6 and 24 months after transplantation, and its magnitude did not differ between male and female patients. Both boys and girls underwent a normal pubertal growth spurt and normal development of secondary sexual characteristics. All adolescent girls had regular menstrual cycles, and one delivered a normal infant 6 years after transplantation. Patients who received transplants before the age of 2 years had poor average growth velocity by the third year after transplantation. Linear growth improved in almost all children and was not affected by the cause of the liver disease that existed before the liver transplantation except that fulminant hepatic failure was associated with poor growth. Long-term improvement of growth in height usually is obtained after liver transplantation in most children with chronic liver diseases. The use of low doses of corticosteroids, administered on an alternate-day basis, contributes to this improvement. Young age of the patient, but not the cause of the chronic liver disease, appears to influence the long-term outcome of linear growth.