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Related Experiment Videos

Renal function and histopathologic changes in children after liver transplantation

J Laine1, L Krogerus, F Fyhrquist

  • 1II Department of Pediatrics, University of Helsinki, Finland.

The Journal of Pediatrics
|December 1, 1994
PubMed
Summary

Pediatric liver transplant patients on triple immunosuppression showed good renal function long-term. Careful monitoring and specific cyclosporine dosing in children help preserve kidney health after orthotopic liver transplantation.

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Area of Science:

  • Nephrology
  • Pediatric Gastroenterology
  • Transplantation Medicine

Background:

  • Cyclosporine use in pediatric orthotopic liver transplantation (OLT) is associated with significant renal function decline.
  • Triple immunosuppression protocols are common in OLT recipients.

Purpose of the Study:

  • To prospectively evaluate renal function and histopathology in children undergoing OLT with triple immunosuppression.
  • To assess the long-term impact of cyclosporine on kidney function in this pediatric population.

Main Methods:

  • Prospective study of 16 children post-OLT over 3 years.
  • Assessed renal function via clearances (Cr-EDTA, PAH, lithium, sodium), electrolytes, and urinary concentration tests.
  • Performed renal biopsies at 18 and 36 months post-transplant.

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Main Results:

  • Mean glomerular filtration rate (GFR) recovered to near pre-transplant levels by 36 months (119.4 ml/min/1.73 m2).
  • Hyperuricemia (17-44%) and reduced urinary concentrating capacity (40-63%) were frequent, while hyperkalemia (13-19%) was transient.
  • Renal biopsies showed mild changes, with tubular atrophy and mesangial alterations, but no severe cyclosporine nephrotoxicity.

Conclusions:

  • Triple immunosuppression with appropriate cyclosporine dosing and vigilant renal monitoring supports preserved renal function in children post-OLT.
  • Long-term renal function in pediatric OLT recipients can be maintained with careful management.
  • Histopathological findings suggest mild, manageable renal changes rather than severe cyclosporine-induced damage.