A preliminary study on the incidence and risk factors of alopecia after pediatric liver transplantation
10.3760/cma.j.cn114015-20220810-00732
- VernacularTitle:儿童肝移植术后脱发发生情况及危险因素的初步研究
- Author:
Xiuping ZHU
1
;
Chen XU
;
Lingyan YU
;
Jiali ZHANG
;
Haibin DAI
Author Information
1. 浙江大学医学院附属第二医院药剂科，杭州 310000
- Publication Type:Journal Article
- Keywords:
Child;
Liver transplantation;
Alopecia;
Alopecia areata;
Immunosuppressive agents;
Tacrolimus
- From:
Adverse Drug Reactions Journal
2023;25(4):218-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence of alopecia after pediatric liver transplantation and its related risk factors.Methods:A retrospective case-control study was used. The subjects were children who underwent liver transplantation in the Second Affiliated Hospital, Zhejiang University School of Medicine from July 2019 to December 2020. The information such as gender, age, primary disease, preoperative body mass index (BMI), graft-to-recipient weight ratio (GRWR), albumin, hemoglobin and total bilirubin before the operation, and blood concentration of tacrolimus were collected from the hospital information system. The follow-up content included whether there was alopecia after surgery, the site of alopecia, the degree of alopecia, the occurrence time and recovery time of alopecia after surgery. The children were divided into alopecia group and non-alopecia group according to whether there were alopecia, and the related indicators were analyzed by univariate analysis, and the results were expressed by odds ratio ( OR) and its 95% confidence interval ( CI). Results:A total of 40 children who met the inclusion criteria were collected, including 20 males and 20 females. The median age at surgery was 20(11, 43) months and the age ranged from 5 months to 13 years. The BMI was (17.1±2.1) kg/m 2 and the GRWR was (2.6±0.7)%. The serum TBil, blood albumin, and hemoglobin before the operation were 120 (27, 191) μmol/L, (33±5) g/L, and (100±14) g/L, respectively. The blood concentration of tacrolimus was (10.37±2.15) μg/L within one month after the operation. Among the 40 children, 17 developed alopecia, including 8 males and 9 females. The severity of alopecia was S 1 in 16 cases and S 2 in 1 case. There were 14 cases of local hair loss and 3 cases of general hair loss. The occurrence time of alopecia in all 17 patients was distributed from 4 days to 9 months after operation, including 15 cases within 1 month after operation, and 2 cases 3 and 9 months after operation, respctively. All patients did not receive symptomatic treatment for alopecia and returned to normal within 1 year after the operation. Univariate analysis showed that low preoperative albumin level and high concentration of tacrolimus within one month after surgery were risk factors for alopecia after pediatric liver transplantation [ (31±4) g/L vs. (34±5) g/L, OR=0.83, 95% CI: 0.71-0.98, P=0.026; (12.0±2.1) μg/L vs. (9.2± 1.2) μg/L, OR=2.80, 95% CI: 1.55-5.05, P=0.001]. Conclusion:Low preoperative albumin level and high concentration of tacrolimus within one month after surgery may be risk factors for alopecia in children after liver transplantation.
