Liver transplantation (LT) is a standard treatment for children with end-stage liver disease, standing at more than 90% survival rate after one yr, and at over a 70% survival rate after five yr. The majority of transplanted children enjoy an excellent quality of life but complications can occur in the long term, and can develop subclinically in otherwise well children; there are various underestimated nutritional and metabolic aspects, including the so-called post-transplant metabolic syndrome (PTMS). During the post-transplant period, the use of immunosuppressants, corticosteroids, calcineurin inhibitors, and the presence of risk factors, including non-alcoholic fatty liver disease (NAFLD), and kidney and bone complications have been largely implicated in PTMS development. Strategies to reduce the progression of PMTS should include careful screening of patients for diabetes, dyslipidemia, and obesity, and to support weight reduction with a carefully constructed program, particularly based on diet modification and exercise. With early identification and appropriate and aggressive management, excellent long-term health outcomes and acceptable graft survival can be achieved.

Nobili, V., DE VILLE DE GOYET, J. (2013). Pediatric post-transplant metabolic syndrome: new clouds on the horizon. PEDIATRIC TRANSPLANTATION, 17(3), 216-223 [10.1111/petr.12065].

Pediatric post-transplant metabolic syndrome: new clouds on the horizon

DE VILLE DE GOYET, JEAN
2013

Abstract

Liver transplantation (LT) is a standard treatment for children with end-stage liver disease, standing at more than 90% survival rate after one yr, and at over a 70% survival rate after five yr. The majority of transplanted children enjoy an excellent quality of life but complications can occur in the long term, and can develop subclinically in otherwise well children; there are various underestimated nutritional and metabolic aspects, including the so-called post-transplant metabolic syndrome (PTMS). During the post-transplant period, the use of immunosuppressants, corticosteroids, calcineurin inhibitors, and the presence of risk factors, including non-alcoholic fatty liver disease (NAFLD), and kidney and bone complications have been largely implicated in PTMS development. Strategies to reduce the progression of PMTS should include careful screening of patients for diabetes, dyslipidemia, and obesity, and to support weight reduction with a carefully constructed program, particularly based on diet modification and exercise. With early identification and appropriate and aggressive management, excellent long-term health outcomes and acceptable graft survival can be achieved.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/20 - Chirurgia Pediatrica e Infantile
English
Obesity; Metabolic Syndrome X; Humans; Disease Progression; End Stage Liver Disease; Quality of Life; Child; Immunosuppressive Agents; Liver Transplantation; Graft Survival; Risk Factors; Treatment Outcome; Adolescent; Diabetes Complications
Nobili, V., DE VILLE DE GOYET, J. (2013). Pediatric post-transplant metabolic syndrome: new clouds on the horizon. PEDIATRIC TRANSPLANTATION, 17(3), 216-223 [10.1111/petr.12065].
Nobili, V; DE VILLE DE GOYET, J
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/108114
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