Evaluation of renal functions in pediatric liver transplantation
Corresponding Author
Mukadder Ayşe Selimoğlu
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Mukadder Ayşe Selimoğlu, Department of Pediatrics, Faculty of Medicine, İnönü University, Malatya, Turkey
Tel.: 90 422 3410660
Fax: 90 422 3411801
E-mail: [email protected]
Search for more papers by this authorİlknur Varol
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorHamza Karabiber
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorYılmaz Tabel
Department of Pediatric Nephrology, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorMeryem Keçeli
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorSezai Yılmaz
Department of General Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorCorresponding Author
Mukadder Ayşe Selimoğlu
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Mukadder Ayşe Selimoğlu, Department of Pediatrics, Faculty of Medicine, İnönü University, Malatya, Turkey
Tel.: 90 422 3410660
Fax: 90 422 3411801
E-mail: [email protected]
Search for more papers by this authorİlknur Varol
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorHamza Karabiber
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorYılmaz Tabel
Department of Pediatric Nephrology, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorMeryem Keçeli
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorSezai Yılmaz
Department of General Surgery, Faculty of Medicine, İnönü University, Malatya, Turkey
Search for more papers by this authorAbstract
AKI is an important complication after LT. As our LT series contains a quite high number of children with ALF unlike published studies, we aimed to determine pre-LT and long-term renal functions in children both with ALF and with CLD. Demographic and disease-related data of 134 transplanted children were evaluated retrospectively. Pre-LT and follow-up GFR and pediatric RIFLE scores were determined. Mean pre-LT GFR was not dependent on the disease presentation or severity of chronic disease. While there was an initial decline until first week of post-LT in CLD children, an increase was observed in ALF. Neither mean GFR nor the pRIFLE on follow-up was different with respect to the type of LT or disease presentation. Mean GFR at first and sixth months were lower in children on cyclosporine compared to tacrolimus (p = 0.001 and p = 0.002, respectively). In conclusion, GFR–time curve was different in children with or without ALF. Type of LT, and severity of the CLD were not risk factors for CKD in any time, but younger age at LT, CLD, and cyclosporine usage were at sixth months of follow-up.
References
- 1Utsumi M, Umeda Y, Sadamori H, et al. Risk factors for acute renal injury in living donor liver transplantation: Evaluation of the RIFLE criteria. Transpl Int 2013: 26: 842–852.
- 2Biancofiore G, Davis CL. Renal dysfunction in the perioperative liver transplant period. Curr Opin Organ Transplant 2008: 13: 291–297.
- 3Cabezuelo JB, Ramírez P, Ríos A, et al. Risk factors of acute renal failure after liver transplantation. Kidney Int 2006: 69: 1073–1080.
- 4Brown RS Jr, Lombardero M, Lake JR. Outcome of patients with renal insufficiency undergoing liver or liver-kidney transplantation. Transplantation 1996: 62: 1788–1793.
- 5Gainza FJ, Valdivieso A, Quintanilla N, et al. Evaluation of acute renal failure in the liver transplantation perioperative period: Incidence and impact. Transplant Proc 2002: 34: 250–251.
- 6Narayanan Menon KV, Nyberg SL, Harmsen WS, et al. MELD and other factors associated with survival after liver transplantation. Am J Transplant 2004: 4: 819–825.
- 7Matloff RG, Arnon R, Saland JM. The kidney in pediatric liver transplantation: An updated perspective. Pediatr Transplant 2012: 16: 818–828.
- 8Goldstein SL. Acute kidney injury in children and its potential consequences in adulthood. Blood Purif 2012: 33: 131–137.
- 9Saner FH, Cicinnati VR, Sotiropoulos G, Beckebaum S. Strategies to prevent or reduce acute and chronic kidney injury in liver transplantation. Liver Int 2012: 32: 179–188.
- 10Wiesmayr S, Jungraithmayr TC, Ellemunter H, et al. Long-term glomerular filtration rate following pediatric liver transplantation. Pediatr Transplant 2005: 9: 604–611.
- 11Kaliciński P, Szymczak M, Smirska E, et al. Longitudinal study of renal function in pediatric liver transplant recipients. Ann Transplant 2005: 10: 53–58.
- 12McCulloch MI, Burger H, Spearman CW, et al. Nephrotoxic effects of immunosuppressant therapy in pediatric liver transplant recipients. Transplant Proc 2005: 37: 1220–1223.
- 13Herlenius G, Hansson S, Krantz M, Olausson M, Kullberg-Lindh C, Friman S. Stable long-term renal function after pediatric liver transplantation. Pediatr Transplant 2010: 14: 409–416.
- 14Schwartz GJ, Work DF. Measurement and estimation of GFR in children and adolescents. Clin J Am Soc Nephrol 2009: 4: 1832–1843.
- 15Akcan-Akikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007: 71: 1028–1035.
- 16 K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease. Evaluation, classification, and stratification. Kidney Disease Outcomes Quality Initiative. Am J Kidney Dis 2002: 39: S1–S246.
- 17Filler G, Yasin A, Medeiros M. Methods of assessing renal function. Pediatr Nephrol 2014: 29: 183–192.
- 18Schwartz GJ, Schneider MF, Maier PS, et al. Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C. Kidney Int 2012: 82: 445–453.
- 19Kivelä JM, Räisänen-Sokolowski A, Pakakinen MP, et al. Long-term renal function in children after liver transplantation. Transplantation 2011: 91: 115–120.
- 20Bishop JR, Burniston MT, Barnfield MC, et al. Renal function evaluated by measured GFR during follow-up in pediatric liver transplant recipients. Pediatr Transplant 2009: 13: 96–103.
- 21Berg UB, Ericzon B, Nemeth A. Renal function before and long after liver transplantation in children. Transplantation 2001: 72: 631–637.
- 22Harambat J, Ranchin B, Dubourg L, et al. Renal function in pediatric liver transplantation: A long-term follow-up study. Transplantation 2008: 86: 1028–1034.
- 23Fine RN. Renal function following liver transplantation in children. Pediatr Transplant 2005: 9: 680–684.
- 24Campbell K, Ng V, Martin S, et al. SPLIT Renal Function Working Group. Glomerular filtration rate following pediatric liver transplantation-the SPLIT experience. Am J Transplant 2010: 10: 2673–2682.
- 25Campbell KM, Yazigi N, Ryckman FC, et al. High prevalence of renal dysfunction in long-term survivors after pediatric liver transplantation. J Pediatr 2006: 148: 475–480.
- 26Herzog D, Martin S, Turpin S, Alvarez F. Normal glomerular filtration rate in long-term follow-up of children after orthotopic livertransplantation. Transplantation 2006: 81: 672–677.
- 27Loo RM, Akiyarajah V, Oh C, Shen L, Aw MM, Prabhakaran K. Comparison between effects of cyclosporine and tacrolimus on glomerular filtration rate in pediatric postorthotopic liver transplant patients. Pediatr Transplant 2006: 10: 55–59.
- 28McDiarmid SV, Colonna JO, Shaked AA, Ament ME, Busuttil RW. A comparison of renal function in cyclosporineand FK-506-treated patients after primary orthotopic liver transplantation. Transplantation 1993: 56: 847–853.
- 29Matloff RG, Diamond R, Weinberg A, Arnon R, Saland JM. Biliary atresia is associated with hypertension. J Pediatr Gastroenterol Nutr 2015: 61: 182–186.
- 30Greenberg N, Roberts WL, Bachmann LM, et al. Specificity characteristics of seven commercial creatinine measurement procedures using enzymatic and Jaffe method principles. Clin Chem 2012: 58: 391–401.