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Journal of Clinical Endocrinology & Metabolism, Vol 81, 1476-1482, Copyright © 1996 by Endocrine Society

ARTICLES

Recombinant human growth hormone improves growth in children receiving glucocorticoid treatment after liver transplantation

S Sarna, I Sipila, K Ronnholm, R Koistinen and C Holmberg
Children's Hospital, University of Helsinki, Finland.

Linear growth is often impaired after successful liver transplantation. The cause is multifactorial; poor graft function and long term glucocorticoid treatment are the main factors responsible. The efficacy and safety of recombinant human GH (rhGH) treatment were assessed in eight growth-retarded children (five boys and three girls) with liver transplants. Immunosuppression comprised azathioprine, cyclosporin, and methylprednisolone. rhGH was administered in a dose of 1 IU/kg x week, given by daily sc injections. The median age at the start of treatment was 9.7 yr (range, 5.9-14.9 yr). All but one of the patients remained prepubertal during treatment. The median growth rate increased from 3.2 to 7.l cm/yr (P = 0.025) and height SD score increased from -3.9 to - 3.1 (P = 0.036) during the first year of rhGH treatment. Serum insulin- like growth factor I and insulin-like growth factor-binding protein-3 levels increased significantly during treatment. Graft function was normal in all except one patient, and no rejections or other serious side-effects were documented. In conclusion, rhGH treatment is effective in short, non-GH-deficient, liver-transplanted children receiving long term glucocorticoid treatment. Due to potential risk of allograft rejection, close monitoring of liver function and immunosuppression is required.


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S. Sarna, K. Hoppu, P. J. Neuvonen, J. Laine, and C. Holmberg
Methylprednisolone Exposure, Rather than Dose, Predicts Adrenal Suppression and Growth Inhibition in Children with Liver and Renal Transplants
J. Clin. Endocrinol. Metab., January 1, 1997; 82(1): 75 - 77.
[Abstract] [Full Text] [PDF]


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