Objective and background: With increasing long-term survival of pediatric liver transplanted patients, systemic complications that do not necessarily involve the liver, have a significant impact on quality of life. Little is known about hearing impairment in children and adults after liver transplantation. Study aim was to evaluate the incidence and risk factors of hearing impairment among liver transplanted children.
Patients and methods: we conducted a prospective study, with standard hearing and high frequency hearing tests administered to children who had undergone liver transplantation. The primary outcome measure was sensorineural hearing impairment over 20 decibels. Independent variables as demographic data as well as primary disease, pre and post-transplant treatments were evaluated. Especially looking at, average doses of aminoglycosides, loop diuretics, vancomycin and blood levels of tacrolimus at 1 week, 1 month, 6 months and 1year post transplantation.
Results: Out of 78 followed, liver transplanted children, 45 (57.6%) fulfilled the inclusion criteria. Excluded, 22%, due to post transplant chemotherapy treatment, developmental delay, psychiatric illness and neurological deficit. Overall, 22/35 (62.8%) agreed to participate. After conducting hearing tests, another two were excluded due to technical difficulties. Finally, 5/20 (25%) had sensorineural hearing loss; (three had hearing impairment at the standard hearing frequency and all five at the high frequency range). The average dose of gentamycin was significantly higher in the hearing impairment group compared to the non- hearing impairment group (37.35 mg/kg versus 15.99 mg/kg respectively, p<0.04).
Conclusions: Despite the small sample size, it is reasonable to conclude that sensorineural hearing impairment is prevalent in pediatric patients following liver transplantation. We recommend that hearing tests should be performed as soon as possible after liver transplantation in order to achieve early detection and treatment of hearing impairment.
