Liver transplantation improves vitamin A, E status in kids with chronic liver disease

Deficiency in fat-soluble vitamins (FSV) is common among children with chronic liver disease, a recent study has found. Liver transplantation appears to improve FSV status.

Researchers enrolled 166 children (median age at inclusion, 9.1 years; 85 girls) awaiting liver transplantation. High-performance liquid chromatography was used to measure plasma levels of vitamins A, D and E upon entry into the waiting list and at 12 months after liver transplantation.

At baseline, 102 of the 153 patients (66.6 percent) with available measurements had vitamin A deficiency. In comparison, 40.6 percent (63 of 155) had vitamin E deficiency while 36.3 percent (56 of 154) had vitamin D deficiency. Patients with deficiencies also showed lower serum albumin levels and had worse disease severity.

One year after liver transplantation, 78, 76 and 77 patients were available for follow-up and provided data. Median plasma retinol concentrations, a reliable biomarker for vitamin A levels, significantly improved, jumping from 0.41 µmol/L at baseline to 0.90 µmol/L after transplantation (p<0.001). Plasma vitamin E changed similarly, increasing from 7.84 µmol/L at baseline to 18.94 µmol/L a year after liver transplantation (p<0.001).

In contrast, no such effect was reported for vitamin D status, which dropped slightly from 25.3 ng/mL at baseline to 21.1 ng/mL at follow-up (p=0.230).

These findings were reflected in the overall prevalence rates of deficiency: 69.2 percent to 29.5 percent for vitamin A, 44.7 percent to 2.6 percent for vitamin E, and 36.3 percent at both time points for vitamin D.