Background: The long-term outcomes of pediatric visceral transplantation in terms of survival, nutritional autonomy, cognitive and physical growth are still not well studied.

Study Design: Single-center retrospective analysis of pediatric patients who underwent visceral transplant between November 2003 and December 2013 and are still alive. Clinical data were used to assess outcomes including patient and graft survival, nutritional autonomy, cognitive and physical growth.

Results: 84 pediatric patients underwent visceral transplant in our center in the study period. 3-, 5-, and 10-year overall patient survival was 77.4%, 77%, and 70%, respectively. 3-, 5-, and 10-year overall graft survival was 76%, 75%, and 68%, respectively. Types of visceral transplants were 29 (34.5%) isolated intestinal transplant, 43 (51.2%) combined liver intestinal transplant, and 12 (14.3%) multi-visceral transplant. Of 84 patients, 61 (72.6%) are still alive. For the survivors, 49% needed supplemental TF, 54.9% needed antimotility medications and 30.2% have diet restrictions. Growth parameters revealed at time of last follow up a mean height Z-score of –1.26 with 62% of children had normal growth, whereas in 38% Z-scores remained lower than –2, concomitant to a delayed growth. Cognitive developmental delay or need of IEP (Individualized Educational Program) were observed in 47.1% of the patients. Median number of medications used at time of last follow up were 10 (2-22). Regarding immunosuppression medications, 60.8% are using Tacrolimus and prednisone, 11.8% are using Tacrolimus, Prednisone and Cellcept, and 27.4% are using Tacrolimus, prednisone and Sirolimus.

Conclusions: Our results demonstrate excellent long-term survival after visceral transplantation in pediatric patients. However, a significant number of patients require nutritional support and suffer from developmental delay.