Extended follow-up of pediatric liver transplantation patients receiving once daily calcineurin inhibitor

Henry Lin, Hector Melin-Aldana, Saeed Mohammad, Udeme D. Ekong, Estella M. Alonso

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We describe longitudinal results in a cohort of pediatric liver transplant patients successfully minimized to once daily CNI monotherapy for longer than five yr and assess changes in liver biochemistries and liver histology. A retrospective chart review of all pediatric liver transplant patients at a single center was performed. Biopsies and serum biochemistries (AST, ALT, total bilirubin, direct bilirubin, INR, creatinine) are reported at time points: PM, five-yr, seven-yr, and nine-yr post-minimization. Biopsies were assessed for inflammation and fibrosis using Ishak and Batts grading systems. Successful minimization to daily CNI monotherapy was defined as normal liver enzymes with no episodes of rejection. Thirty-three patients have successfully remained on once daily CNI for >5 yr, and 19/33 of these patients have serial liver biopsies available for review. We report on the clinical and histological findings of these 19 patients. All 19 patients continue to have normal liver biochemistries. On post-minimization biopsies, fibrosis progressed by ≥2 stages in one patient (5.3%) despite normal liver biochemistries. Carefully selected patients can tolerate minimization to once daily CNI monotherapy as few have progression of fibrosis.

Original languageEnglish (US)
Pages (from-to)709-715
Number of pages7
JournalPediatric transplantation
Volume19
Issue number7
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Liver Transplantation
Pediatrics
Liver
Biochemistry
Biopsy
Fibrosis
Bilirubin
Transplants
International Normalized Ratio
Calcineurin Inhibitors
Creatinine
Histology
Inflammation
Enzymes
Serum

Keywords

  • calcineurin inhibitors
  • immunosuppression minimization
  • liver transplant
  • pediatric transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Extended follow-up of pediatric liver transplantation patients receiving once daily calcineurin inhibitor. / Lin, Henry; Melin-Aldana, Hector; Mohammad, Saeed; Ekong, Udeme D.; Alonso, Estella M.

In: Pediatric transplantation, Vol. 19, No. 7, 01.11.2015, p. 709-715.

Research output: Contribution to journalArticle

Lin, Henry ; Melin-Aldana, Hector ; Mohammad, Saeed ; Ekong, Udeme D. ; Alonso, Estella M. / Extended follow-up of pediatric liver transplantation patients receiving once daily calcineurin inhibitor. In: Pediatric transplantation. 2015 ; Vol. 19, No. 7. pp. 709-715.
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