Related Experiment Video

Updated: Aug 18, 2026

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction
18:47

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction

Published on: March 7, 2013

Renal function before and long after liver transplantation in children

U B Berg1, B G Ericzon, A Nemeth

  • 1Department of Paediatrics, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.

Transplantation
|September 7, 2001
PubMed

Insights

Orthotopic liver transplantation (OLT) in children impairs renal function, which declines further post-transplant. Accurate measurement of glomerular filtration rate (GFR) is crucial, as creatinine clearance is unreliable.

Area of Science:

  • Pediatric Nephrology
  • Hepatology
  • Transplantation Medicine

Background:

  • Renal dysfunction is common in children with liver disease and can worsen after liver transplantation.
  • Current methods for assessing renal function in these patients are often inaccurate.
  • This study investigates renal function changes before and after liver transplantation using precise methods.

Purpose of the Study:

  • To analyze the impact of underlying diseases, hypertension, and immunosuppressive agents on renal function post-liver transplantation.
  • To evaluate changes in glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) after OLT.
  • To compare the accuracy of inulin clearance with estimated creatinine clearance for GFR determination.

Main Methods:

  • Studied 46 children before and annually after orthotopic liver transplantation (OLT).
  • Measured glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) using inulin and paraaminohippuric acid clearances.
  • Compared inulin clearance with formula creatinine clearance for GFR estimation.

Main Results:

  • GFR and ERPF decreased after OLT and continued to decline in the initial years.
  • Patients with extrahepatic biliary atresia and tumors had higher GFR post-OLT compared to those with metabolic disorders.
  • Creatinine clearance calculations showed significant disagreement with inulin clearance-based GFR.
  • Tacrolimus-treated patients showed higher GFR at 4 years compared to cyclosporine-treated patients.
  • Antihypertensive treatment was associated with lower GFR.

Conclusions:

  • Orthotopic liver transplantation (OLT) reduces renal function in children, with further decline in the early post-transplant years.
  • Metabolic disorders and antihypertensive treatment are linked to the lowest GFR.
  • Formula creatinine clearance is an inaccurate method for determining GFR in pediatric liver transplant recipients.
Abstract

More Related Videos

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt12:27

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

Published on: May 7, 2015

Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation08:39

Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation

Published on: November 7, 2020

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...