Growth and developmental considerations in pediatric liver transplantation

One of the most critical differences in the posttransplant care of children and adults is the essential requirement in children to maintain a state of health that supports normal physical and psychological development. These 2 aspects of health have been studied both separately and jointly because the outcomes may be interrelated and share common risk factors. Several aspects of physical growth and cognitive development have been reported in children receiving liver transplantation, primarily in single-center, retrospective series. The effect of chronic liver disease, frequently complicated by malnutrition, on growth potential and neurodevelopmental processes is poorly understood. Furthermore, the effect of chronic posttransplant immunosuppressive exposure, particularly that of calcineurin inhibitors, on central nervous system development is not known.