10 February 2025

Kelly D.: Long term liver transplant outcomes

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Prof Dr Deirdre Kelly is today’s ESPGHAN podcast series guest,  speaking on the long-term care of paediatric allograft-liver patients and the findings gleaned from protocol-biopsy studies.  These have uncovered inflammation and fibrosis that are not clinically apparent ; although shifts in immunosuppressive regimen can ablate inflammation, fibrosis persists.  (These findings come from patients whose biopsy procedures were not prompted by intercurrent disease.  Thus long-term changes that led to clinically manifest biliary-tract injury, for example, were invisible a priori.)  Recent problems include reluctance of adult hepatologists to conduct protocol biopsies in “ex-paediatric” patients – the adults whom they usually follow after liver transplantation simply don’t live long enough to make chronic changes a concern. But studies continue, headed by Dr Steffen Hartlief of Tübingen (Germany).If you like to know more or if you are interested in contributing to the Graft Injury Group (GIG), please contact Dr. Steffen Hartleif, coordinator paediatric liver transplant programTübingen, Germany.

phone: +49 7071 29-81328 (secretary) or email: steffen.hartleif@med.uni-tuebingen.de

 

Literature :

Kelly D et al.  Late graft hepatitis and fibrosis in pediatric liver allograft recipients:  Current concepts and future developments.    Liver Transpl 2016 Nov 22(11):1593-1602.  Doi:  10.1002/lt.24616.  PMID:  27543906.

Ruth N et al.  What is the long-term outlook for young people following liver transplant?  A single-centre retrospective analysis of physical and psychosocial outcomes.  Pediatr Transplant 2020 Nov 24(7):e13782.  Doi:  10.1111/petr.13782.  Epub 2020 Jul 17.  PMID:  32678500.

Wang HL.  Asymptomatic allograft fibrosis in pediatric liver transplantation:  Potential clinical implications.  Transplantation 2023 Nov 1 107(11):2314-2315.  Doi:  10.1097/TP.0000000000004604.  Epub:  2023 May 5.  PMID:   37143196.

Dr. Kelly´s favourite song: Danny Boy - Eva Cassidy https://open.spotify.com/track/0ZMdTY4ZBMyagiv9GBd06j?si=f8b52ee663b643f0 

ESPGHAN favourite Songs can be found on Spotify https://open.spotify.com/playlist/0YIHKjxITLEm9XNyHyypTo