Growth after Solid-organ Transplantation

One of the ultimate goals of solid organ transplantation in children is to attain a normal adult height. Many children with organ failure present with severe growth retardation already at time of transplantation. This is due to the metabolic/hormonal consequences of organ dysfunction, malnutrition, infections, and markedly influenced by the primary disease. Despite excellent organ function catch-up growth in children after solid-organ transplantation remains often incomplete. Of note, remarkably similar factors impact on growth in pediatric kidney, liver, heart, and lung recipients. Beside genetic factors, age and degree of growth failure at time of transplantation, malnutrition, treatment with corticosteroids and graft function have to be mentioned as factors significantly influencing post transplant growth. During the last 10 years great efforts have been made to improve pre-transplant growth by providing adequate nutrition and/or growth hormone therapy. New immunosuppressive protocols allow to minimize or even to avoid exposure to corticosteroids in the majority of patients. Thus, attaining a normal adult height is within reach for children requiring solid-organ transplantation.