Differences in anthropometric parameters and the IGF-I-IGFBP3 axis betweenliver and venal transplant children

Background. Growth can be differently altered after liver and renal transpl antation (Tx) in childhood. Methods, We compared graft function, linear growth, immunosuppression and s erum IGF-I (RIA) and IGFBP3 (IRMA) concentrations in 15 liver (5.6+/-1.1 ye ars old) and 17 renal (7.4+/-0.1 years old) Tx patients who were followed f or 4-6 years. Results. Graft function was normal post-liver Tx, although in renal recipie nts creatinine clearance decreased significantly during follow-up, Liver Tx children presented an increase in mean height of 0.92+/-0.2 SDS (P<0.01) b eyond the 2nd year post-Tx, although in renal Tx patients height SDS did no t improve. Immunosuppressive corticoid dosage could be decreased and discon tinued in liver Tx patients, while in renal recipients it was maintained be tween 0.18+/-0.01 and 0.16+/-0.02 mg/kg/day. At 3.7+/-0.4 years post Tx, liver Tx patients presented higher mean serum I GF-I level, lower mean serum IGFBP3 value, leading to a higher mean IGF-I/I GFBP3 molar ratio, P<0.001. Conclusions. We found that while catch up growth could be achieved after li ver Tx, height SDS did not improve after renal Tx, This may be related to a reduced renal graft function and/or to differences in immunosuppressive co rticoid dosage, In children with renal transplants a challenge for the futu re will reside in making it possible to substitute steroid therapy without altering graft function.