Long-Term Follow-Up of Renal Function in Children after Liver Transplantation—A Single Center Retrospective Study
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Analysed Data
2.3. Assessment of Renal Function
2.4. Immunosuppression Protocol
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Assessment of Renal Filtration Function
3.3. Immunosuppression and Renal Function after LT
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n = 61 Mean ± SD | Median (IQR) | |
---|---|---|
Age at transplant (years) | 1.7 (±1.6) | 1.2 (0.66–2.04) |
Height (cm) | 79 (±14.4) | 75 (70–86) |
Body mass (kg) | 10.2 (±4.4) | 9.8 (7–12) |
Gender (male/female) | 19/42 | |
Donor type (living/deceased) | 58/3 | |
Liver failure (patients, %) ALF ChLF Acute-on-chronic liver failure Liver tumors | 7 (11%) 49 (80%) 1 (2%) 4 (7%) | |
PELD/MELD | 17 (±11) | 18 (11–20) |
Creatinine (mg/dL) | 0.3 (±0.2) | 0.2 (0.2–04) |
Urea (mg/dL) | 23.7 (±12.5) | 21 (15–29) |
Creatinine-based estimated GFR, mL/min/1.73 m2 | 132 (±63) | 130 (93–155) |
Continuous veno-venous hemodiafiltration (patients, %) | 4 (6.6%) |
eGFRcys > 90 mL/min/1.73 m2 | eGFRcys < 90 mL/min1.73 m2 | p Value | |
---|---|---|---|
Creatinine (mg/dL) | n = 30 | n = 31 | |
1 year after LT | 0.3 | 0.4 | <0.02 |
5 years after LT | 0.32 | 0.44 | <0.0003 |
10 years after LT | 0.45 | 0.59 | <0.000001 |
Urea (mg/dL) | |||
1 year after LT | 22 | 28 | <0.007 |
5 years after LT | 19 | 26 | <0.02 |
10 years after LT | 20 | 27 | <0.002 |
eGFRcr (mL/min/1.73 m2) | |||
Before LT | 127 | 137 | =0.36 |
At discharge after LT | 98 | 91 | =0.26 |
1 year after LT | 115 | 90 | <0.04 |
5 years after LT | 141 | 106 | <0.0007 |
10 years after LT | 134 | 103 | <0.000001 |
Age at LT (years) | 1.00 | 1.33 | =0.07 |
Acute liver failure | 4 (13%) | 3 (10%) | =0.65 |
Dialysis before LT | 2 (7%) | 2 (6%) | =0.97 |
Intensive care unit stay (days) | 7 | 4 | =0.09 |
Anhepatic phase duration (min) | 105 | 105 | =0.74 |
n = 61 | % | |
---|---|---|
Tacrolimus | 47 | 77.5% |
Sirolimus | 5 | 8% |
Cyclosporine A | 3 | 5% |
Mycophenolate mofetil (MMF) | 2 | 3% |
Corticosteroids | 2 | 3% |
Tacrolimus + sirolimus | 1 | 1.5% |
Variables | Unadjusted HR (95% CI) | p-Value | Adjusted HR (95% CI) | p-Value |
---|---|---|---|---|
Age <2 y at LT | 0,27 (0.12–0.6) | 0.001 | 0.15 (0.05–0.41) | 0.0003 |
eGFR before LT | 1 (0.99–1.00) | 0.7 | - | - |
eGFR 1y after LT | 1 (0.99–1.01) | 0.47 | - | - |
Tac0 concentration <4 ng/mL in distant follow-up | 0.51 (0.21–1.22) | 0.13 | 0.36 (0.14–0.92) | 0.03 |
Range | Mean; ±SD | Median; (IQR) | |
---|---|---|---|
Follow-up (years) | 10–17.3 | 12.9; ±2 | 12.7; (11–14) |
Creatinine (mg/dL) | 0.33–1.3 | 0.63; ±0.2 | 0.6; (0.5–07) |
Urea (mg/dL) | 10–103 | 26; ±12 | 24; (21–30) |
Cystatin C (mg/L) | 0.53–2.14 | 0.92; ±0.27 | 0.87; (0.75–0.99) |
Total protein (g/L) | 13.8–88.5 | 70; ±11 | 72; (68–76) |
Albumin (g/L) | 32–49 | 43; ±4 | 42; (35.6–44.6) |
Microalbuminuria (mg/L) | 3–646 | 40; ±106 | 7.9; (4.1–23.2) |
eGFRcr (mL/min/1.73 m2) | 49–199 | 113; ±30 | 111; (94–131) |
eGFRcys (mL/min/1.73 m2) | 41–150 | 90; ±18 | 89; (80–101) |
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Kowalewski, G.; Kaliciński, P.; Stefanowicz, M.; Grenda, R.; Czubkowski, P.; Szymczak, M. Long-Term Follow-Up of Renal Function in Children after Liver Transplantation—A Single Center Retrospective Study. Children 2021, 8, 633. https://0-doi-org.brum.beds.ac.uk/10.3390/children8080633
Kowalewski G, Kaliciński P, Stefanowicz M, Grenda R, Czubkowski P, Szymczak M. Long-Term Follow-Up of Renal Function in Children after Liver Transplantation—A Single Center Retrospective Study. Children. 2021; 8(8):633. https://0-doi-org.brum.beds.ac.uk/10.3390/children8080633
Chicago/Turabian StyleKowalewski, Grzegorz, Piotr Kaliciński, Marek Stefanowicz, Ryszard Grenda, Piotr Czubkowski, and Marek Szymczak. 2021. "Long-Term Follow-Up of Renal Function in Children after Liver Transplantation—A Single Center Retrospective Study" Children 8, no. 8: 633. https://0-doi-org.brum.beds.ac.uk/10.3390/children8080633