SERUM GH-BINDING PROTEIN BEFORE AND AFTER LIVER TRANSPLANTATION IN CHILDREN WITH CONGENITAL BILIARY ATRESIA

Background. Liver cirrhosis occurring before 1 year of age can affect a child’s development. Liver transplantation is the only radical treatment for decompensated cirrhosis. In biliary atresia, cirrhosis develops during the first months of life. The duration of cirrhosis in biliary atresia may vary from palliative Kasai portoenterostomy (PE) to liver transplantation. Developmental abnormalities in children with biliary atresia have been shown to occur both before and after liver transplantation. Association between duration of liver cirrhosis and psychomotor development of children has been underestimated.Objective: to determine the chances of developmental delay in children depending on the cirrhosis persistence duration.Materials and methods. The study enrolled 83 children with biliary atresia (47 children underwent palliative Kasai PE, 36 children with liver transplantation did not undergo Kasai PE). All children had their psychomotor development assessed before PE and 12 months after PE using the Griffiths psychomotor developmental scale (translation and adaptation by E.S. Keshishian) for children up to 24 months of age. Statistical analysis was performed by calculating odds ratios with 95% confidence intervals.Results. Comparative analysis showed that in the subgroup of children who underwent Kasai PE, cirrhosis persistence before transplantation was 2.6 months longer than in children without Kasai PE (p = 0.011). The odds of developmental delay in preparation for liver transplantation were 3.3 times higher in the subgroup of children who underwent Kasai palliative PE compared to children without palliative (95%, CI 1.35–8.31). The odds of developmental delay 12 months after liver transplantation were 4.4 times higher in the subgroup of children who underwent palliative Kasai PE than in children without the palliative care (95% CI 1.54–12.5).Conclusion. Children who underwent liver transplantation after palliative surgical treatment had lower levels of psychomotor development than children without palliative Kasai PE both before and 12 months after liver transplantation (p = 0.0018, p = 0.01 respectively).

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Evaluation of ventricular systolic function by speckle tracking technique in patients with biliary atresia before and after liver transplantation

Scientific Reports ◽

10.1038/s41598-021-97096-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Márcio Miranda Brito ◽

Helena Thie Miyatani ◽

Paulo Renato de Alencar Pereira ◽

Ana Cristina Aoun Tannuri ◽

Uenis Tannuri

Keyword(s):

Liver Transplantation ◽

Left Ventricle ◽

Biliary Atresia ◽

Left Ventricular Mass ◽

Speckle Tracking ◽

Left Ventricular Mass Index ◽

Left Ventricular ◽

Two Dimensional ◽

Post Transplant ◽

Before And After

AbstractTo evaluate the ventricular function of patients with biliary atresia (BA) before and after liver transplantation using two-dimensional speckle tracking. Observational, analytical study with healthy control group, volunteers. We recruited patients from 0 to 18 years old who were candidates for liver transplantation and patients after six months of liver transplantation performed for BA from January 1997 to August 2015 at Children’s Institute of São Paulo University Medical School. The patients were submitted to a complete conventional echocardiographic study. After that, the images were captured for global longitudinal strain (GLS). A blood sample was collected for brain natriuretic peptide (BNP) level. Ejection fraction obtained by Simpson’s method was significantly higher in the hepatic pre-transplantation group (p < 0.001), as well as left atrial size (p < 0.001) and left ventricle size (p = 0.039). The left ventricular mass index was significantly higher in pre-transplantation group (p < 0.001). The left atrium volume (p = 0.008) and the left ventricular mass index (p t = 0.035) were higher in the post-transplant group. It was observed that the lower the BNP, the lower/more negative the GLS in the post-transplant group (p = 0.038 and r = 0.427). Significant reduction in the overall longitudinal strain of the left ventricle was detected before (p = 0.01) and after liver transplantation (p = 0.019). A subclinical left ventricular systolic dysfunction was evidenced by two-dimensional speckle tracking technique before and after liver transplantation, even when compared to normal values of the last pediatric meta-analysis.

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Educational intervention for liver transplantation candidates

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692013000100018 ◽

2013 ◽

Vol 21 (1) ◽

pp. 419-425 ◽

Cited By ~ 4

Author(s):

Karina Dal Sasso Mendes ◽

Orlando de Castro e Silva Junior ◽

Luciana da Costa Ziviani ◽

Fabiana Murad Rossin ◽

Márcia Maria Fontão Zago ◽

...

Keyword(s):

Liver Transplantation ◽

Patient Education ◽

Research Design ◽

Educational Intervention ◽

Research Data ◽

Intervention Method ◽

Final Sample ◽

Education Strategy ◽

Before And After ◽

Quasi Experimental

OBJECTIVE: The objective in this study was to analyze candidates' knowledge on the liver transplantation process before and after putting in practice an educational intervention. METHOD: A quasi-experimental, one-group pretest-posttest research design was adopted. The final sample included 15 subjects. Research data were collected between January and March 2010 in three phases, which were: pretest, implementation of the educational intervention (two meetings) and posttest. RESULTS: The results evidenced significant cognitive gains after the intervention, with improvements in the participants' performance . CONCLUSIONS: The research presents evidence that putting in practice a patient education strategy can enhance candidates' knowledge on the liver transplantation process and consequently contribute to a successful treatment.

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De novo gastric cancer developing after liver transplantation from deceased donor for biliary atresia: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01210-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Naruki Higashidate ◽

Suguru Fukahori ◽

Shinji Ishii ◽

Nobuyuki Saikusa ◽

Naoki Hashizume ◽

...

Keyword(s):

Gastric Cancer ◽

Liver Transplantation ◽

Biliary Atresia ◽

De Novo ◽

Epigastric Pain ◽

Gastroesophageal Junction ◽

Deceased Donor ◽

Lymphoproliferative Disease ◽

Endoscopic Examination ◽

De Novo Malignancy

Abstract Background Apart from Kasai’s procedure, liver transplantation (LTx) has dramatically improved the outcome of children with biliary atresia (BA). However, de novo malignancy has been reported to be one of the major causes of late mortality after LTx among adults. We report a rare case of de novo gastric cancer developing after LTx for BA received during childhood. Case presentation A 21-year-old male patient who had undergone LTx for BA at age 2 years occasionally visited our outpatient clinic due to symptoms of epigastric pain and dysphagia. Endoscopic examination and computed tomography revealed advanced gastric cancer at the gastroesophageal junction with multiple liver metastases. Despite systemic chemotherapy, the disease progressed, resulting in patient’s death 2 years after the diagnosis. Conclusions De novo malignancy in the absence of post-transplant lymphoproliferative disease is rare in pediatric patients who received LTx. To the best of our knowledge, no report has been available on the development of gastric cancer after LTx for BA during childhood. Primary physicians should therefore establish a follow-up plan for patients receiving LTx for BA considering the potential for the development of de novo malignancy, including gastric cancer, despite its rarity.

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