Glomerular abnormalities in children undergoing orthotopic liver transplantation

• Published in: Pediatric nephrology (Berlin, West) Vol. 6; no. 5; pp. 407 - 411
• Main Authors: CHIN, S. E, AXELSEN, R. A, CRAWFORD, D. H. G, ENDRE, Z. H, LYNCH, S. V, BALDERSON, G. A, STRONG, R. W, SHEPHERD, R. W, BURKE, J. R, FLEMING, S. J
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Heidelberg Springer 01-09-1992
• Subjects: Albuminuria - metabolism; Biological and medical sciences; Biopsy; Child, Preschool; Creatinine - urine; Female; Fluorescent Antibody Technique; Humans; Immunoglobulin A - analysis; Immunoglobulin G - analysis; Immunoglobulin M - analysis; Infant; Kidney Diseases - epidemiology; Kidney Diseases - pathology; Kidney Diseases - physiopathology; Kidney Glomerulus - abnormalities; Kidney Glomerulus - pathology; Liver Diseases - complications; Liver Diseases - pathology; Liver Diseases - surgery; Liver Transplantation - pathology; Male; Medical sciences; Nephrology. Urinary tract diseases; Prospective Studies; Human; Glomerulonephritis; Urinary system disease; Liver; Hepatic disease; Renal disease; Transplantation; Kidney; Case study; Cirrhosis; Concomitant disease; Digestive diseases; Child
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/BF00873994

A prospective study of renal function was undertaken on an unselected group of 8 children with chronic progressive liver disease on whom a renal biopsy was performed subsequently at the time of orthotopic liver transplantation. Two patients had abnormal urinalyses and 2 elevated urinary albumin/creatinine ratios. The remainder had no clinical evidence of renal dysfunction. All had normal serum creatinine concentrations. Glomerular abnormalities were present in all renal biopsies and were of two types: hepatic glomerulosclerosis (n = 5) and minor glomerular abnormalities (n = 3). IgM immunofluorescence was present in all biopsies and IgA in 6. Elevated serum immunoglobulin levels were observed in all patients, with IgM elevation in 6, IgA in 4 and IgG in 6. C3 and/or C4 were reduced in 5 patients and increased circulating immune complexes containing IgM were noted in 4. The clinical significance of these cirrhosis-associated glomerular abnormalities can only be established by long-term follow-up studies after orthotopic liver transplantation.