Abstract

Objectives: Minimal research has been conducted on the effect of nutritional status on acute post-transplant outcomes in pediatric liver transplant patients. The purpose of this study was to determine the effect of pre-transplant nutritional status (height, weight, albumin, hemoglobin, Vitamin A, Vitamin E, Vitamin D, mean corpuscular volume (MCV), calcium, magnesium and phosphorus) on acute post-transplant outcomes (length of hospital stay and infection rate). Methods: We conducted a retrospective chart review of all children who received a liver transplant between January 1999 and December 2008 at the Hospital for Sick Children in Toronto. Results: Data were analyzed for a total of 128 children; average age at transplant was 6 years. Children with a height z-score ≤ -2.5 had a longer length of stay and greater number of infections than those who had a height z-score of > -2.5 (54.7 vs. 34.8 d). In addition, those with a height z-score of ≤ -1.5 had a longer length of stay and more infections than those with a height z-score of > -1.5 (45 vs. 35 d). Conclusions: The acute post-transplant outcomes of pediatric patients who underwent liver Transplantation for liver failure was significantly affected by height z-scores pre-transplantation. Children with poor linear growth had a length of stay up to 20 days longer and a 30% higher infections rate than those with improved linear growth. Children with liver disease should be aggressively monitored pre-transplant to ensure adequate linear growth.

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