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Long-Term Follow-Up of Renal Function in Children after Liver Transplantation-A Single Center Retrospective Study

Grzegorz Kowalewski1, Piotr Kaliciński1, Marek Stefanowicz1

  • 1Department of Pediatric Surgery and Organ Transplantation, Children's Memorial Health Institute, 04-730 Warsaw, Poland.

Children (Basel, Switzerland)
|August 27, 2021
PubMed

Insights

Chronic kidney disease (CKD) is a significant risk after pediatric liver transplantation (LT). Maintaining high tacrolimus levels increased microalbuminuria, a key CKD indicator, highlighting the need for vigilant patient monitoring.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Medicine
  • Immunosuppression Therapy

Background:

  • Chronic kidney disease (CKD) is a frequent complication following liver transplantation (LT).
  • Prevalence of CKD in pediatric LT recipients varies with immunosuppression and era.
  • Long-term outcomes require further investigation, especially with modern treatments.

Purpose of the Study:

  • To assess the incidence and risk factors of CKD in pediatric LT patients.
  • To evaluate the association between tacrolimus levels and renal function.
  • To determine the significance of microalbuminuria in predicting CKD post-LT.

Main Methods:

  • Retrospective analysis of 61 pediatric LT patients with ≥10 years follow-up.
  • Assessment of estimated glomerular filtration rate (eGFR) and renal tubular function.
  • Monitoring of tacrolimus blood concentrations and screening for microalbuminuria.

Main Results:

  • CKD was diagnosed in 3% of patients at 12 years post-LT.
  • Tacrolimus concentrations >4 ng/mL were linked to increased microalbuminuria.
  • Microalbuminuria was identified as a risk factor for CKD development.

Conclusions:

  • Regular, comprehensive assessment is crucial for pediatric LT patients in long-term follow-up.
  • Monitoring microalbuminuria aids in early detection of kidney damage.
  • Optimizing immunosuppression may be key to preventing CKD after LT.

Keywords:
chronic kidney diseaseimmunosuppressionliver transplantation

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