Early post‐transplant hyperbilirubinemia is a possible predictive factor for developing neurological complications in pediatric living donor liver transplant patients receiving tacrolimus
The cause of post‐transplant CNI ‐ NC s is multifactorial and not ascribed solely to CNI toxicity. A total of 90 children (aged <20 years) who underwent LDLT were evaluated to investigate the predictive factors associated with CNI ‐ NC s. Twelve patients (13.3%) developed CNI ‐ NC s after LDLT (age range, 2‐15 years). The symptoms of CNI ‐ NC s were seizures, VD, and stupor. The median onset of CNI ‐ NC s was 10 days (range, 5‐30 days) post‐transplant. In the univariate analysis, higher recipient age at LDLT , donor age and recipient's BW, lower actual GV/SLV and TAC dosage/BW, and higher mean T‐Bil and sodium level for 7 days after transplantation were independently significantly associated with TAC ‐ NC s. Multivariate analysis showed that the T‐Bil level in the first week after LDLT was the only significant independent predictive factor for TAC ‐ NC s ( HR , 1.588; 95% CI, 1.042‐2.358; P =.031). In conclusion, CNI ‐ NC s occurred most frequently in children over 5 years and were associated with hyperbilirubinemia for 7 days post‐transplant, regardless of TAC levels. The transplant team should refer to a neurologist to define the diagnosis and to collaborate to resolve the neurological problems..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Pediatric transplantation - 21(2017), 2 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sato, Kazushige [VerfasserIn] |
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| Links: |
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| Themen: |
Bilirubin |
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| doi: |
10.1111/petr.12843 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC1993495878 |
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| 245 | 1 | 0 | |a Early post‐transplant hyperbilirubinemia is a possible predictive factor for developing neurological complications in pediatric living donor liver transplant patients receiving tacrolimus |
| 264 | 1 | |c 2017 | |
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| 520 | |a The cause of post‐transplant CNI ‐ NC s is multifactorial and not ascribed solely to CNI toxicity. A total of 90 children (aged <20 years) who underwent LDLT were evaluated to investigate the predictive factors associated with CNI ‐ NC s. Twelve patients (13.3%) developed CNI ‐ NC s after LDLT (age range, 2‐15 years). The symptoms of CNI ‐ NC s were seizures, VD, and stupor. The median onset of CNI ‐ NC s was 10 days (range, 5‐30 days) post‐transplant. In the univariate analysis, higher recipient age at LDLT , donor age and recipient's BW, lower actual GV/SLV and TAC dosage/BW, and higher mean T‐Bil and sodium level for 7 days after transplantation were independently significantly associated with TAC ‐ NC s. Multivariate analysis showed that the T‐Bil level in the first week after LDLT was the only significant independent predictive factor for TAC ‐ NC s ( HR , 1.588; 95% CI, 1.042‐2.358; P =.031). In conclusion, CNI ‐ NC s occurred most frequently in children over 5 years and were associated with hyperbilirubinemia for 7 days post‐transplant, regardless of TAC levels. The transplant team should refer to a neurologist to define the diagnosis and to collaborate to resolve the neurological problems. | ||
| 540 | |a Nutzungsrecht: © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd | ||
| 650 | 4 | |a children | |
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| 700 | 1 | |a Kobayashi, Yoshinobu |4 oth | |
| 700 | 1 | |a Nakamura, Atsushi |4 oth | |
| 700 | 1 | |a Fukushima, Daizo |4 oth | |
| 700 | 1 | |a Satomi, Susumu |4 oth | |
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| 856 | 4 | 1 | |u http://dx.doi.org/10.1111/petr.12843 |3 Volltext |
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