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Published on: October 11, 2014

Longitudinal study of renal function in pediatric liver transplant recipients

Piotr Kaliciński1, Marek Szymczak, Ewa Smirska

  • 1Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, Warsaw, Poland. piokal@czd.waw.pl

Annals of Transplantation
|October 13, 2005
PubMed

Insights

Pediatric liver transplant recipients experienced reduced kidney function within 12 months, but it stabilized long-term. Regular DTPA GFR monitoring is recommended to track renal health post-transplant.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Medicine
  • Immunosuppression Therapy

Background:

  • Liver transplantation in children can impact long-term renal function.
  • Monitoring kidney health is crucial for pediatric transplant recipients.

Purpose of the Study:

  • To prospectively evaluate long-term renal function in pediatric liver transplant recipients.
  • To assess changes in renal function markers over 36 months post-transplantation.

Main Methods:

  • Prospective study of 50 children (1-18 years) undergoing liver transplantation.
  • Renal function tests including serum creatinine (sCr), glomerular filtration rate (GFR), effective renal plasma flow (ERPF), creatinine clearance, renal Doppler ultrasound, and ambulatory blood pressure monitoring (ABPM) were performed.
  • Data collected pre-transplant and at multiple time points during a 36-month follow-up period.

Main Results:

  • A significant reduction in renal filtration function (increased sCr, decreased GFR, ERPF, creatinine clearance) was observed within 12 months post-transplantation.
  • Renal function generally stabilized after 12 months, with no progression to advanced chronic kidney disease (CKD) stages 4 or 5 in any patient.
  • The Schwartz formula was unreliable for assessing renal function in this population. Arterial hypertension was more prevalent in the cyclosporine group compared to the tacrolimus group.

Conclusions:

  • While some pediatric liver transplant recipients may experience renal damage, most maintain stable renal function at 36 months post-transplant.
  • Yearly DTPA GFR measurements are recommended for all pediatric liver transplant recipients until adulthood to detect potential renal injury progression.
  • Close monitoring of renal function is essential for managing long-term outcomes in pediatric liver transplant survivors.
Abstract

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