RECOMBINANT HUMAN GROWTH-HORMONE IMPROVES GROWTH IN CHILDREN RECEIVING GLUCOCORTICOID TREATMENT AFTER LIVER-TRANSPLANTATION

Linear growth is often impaired after successful liver transplantation . The cause is multifactorial; poor graft function and long term gluco corticoid treatment are the main factors responsible. The efficacy and safety of recombinant human GH (rhGH) treatment were assessed in eigh t growth-retarded children (five boys and three girls) with liver tran splants. Immunosuppression comprised azathioprine, cyclosporin, and me thylprednisolone. rhGH was administered in a dose of 1 IU/kg week, giv en by daily sc injections. The median age at the start of treatment wa s 9.7 yr (range, 5.9-14.9 yr). All but one of the patients remained pr epubertal during treatment. The median growth rate increased from 3.2 to 7.1 cm/yr (P = 0.025) and height so 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 no rmal in all except one patient, and no rejections or other serious sid e-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 rej ection, close monitoring of liver function and immunosuppression is re quired.