Chronic Hepatitis In Pediatric Liver Transplant Patients
Chronic hepatitis in children
A new study on the long-term outcome of children undergoing liver transplants found that chronic hepatitis (CH) was common and that it was not detectible using standard blood tests. The presence of autoantibodies (antibodies that attack the body's own tissues) in these patients indicates that although not fully understood, CH may be related to the immune response.
The results of this study appear in the May 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience.
Children normally undergo liver transplants for diseases that do not recur and are potentially curable by the procedure. Although their long-term survival rates are over 80 percent, little is known about tissue changes that occur over time in these young patients. "An important question within the field of paediatriac liver transplantation is whether children who have undergone successful transplantation can expect a normal life expectancy or whether there will be a gradual decline in liver function and eventual graft loss," the authors write.
Led by Helen M. Evans of the Birmingham Children's Hospital in Birmingham, United Kingdom, the study involved children who received liver transplants at the hospital's Liver Unit between 1983 and 1996. Patients underwent standard liver function tests, sonograms and liver biopsies at approximately 1, 5 and 10 years following transplant, and autoantibodies were measured at 5 and 10 years. A total of 113 children had liver biopsies at the one year mark, 135 had biopsies after 5 years, and 64 underwent biopsies at 10 years.
The results showed that there was a decrease over time in the proportion of biopsies considered to be normal, with chronic hepatitis being the most common abnormality (22 percent at 1 year, 43 percent at 5 years, 64 percent at 10 years). While liver function tests at 5 years were not significantly different in children who had chronic hepatitis, the presence of autoantibodies was significantly higher at 5 and 10 years in children with