Long-Term Survival and Kidney Function in Pediatric Patients Following Liver Transplantation: A 15-Year Retrospective Cohort Study

• Published in: Children (Basel) Vol. 9; no. 10; p. 1544
• Main Authors: Son, Rin, Suh, Sung Yun, Cho, Yoon Sook, Rhie, Sandy Jeong
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01-10-2022; MDPI
• Subjects: Age; Analysis; Antihypertensives; Biopsy; Children; Chronic kidney failure; Cohort analysis; Cytomegalovirus; Development and progression; Health aspects; Hospitals; Hypertension; Infections; Kidney diseases; kidney function; Liver; Liver diseases; liver transplantation; Liver transplants; long-term survival; Medical research; Medicine, Experimental; Patient outcomes; Patients; pediatric patients; Pediatrics; Risk factors; Survival analysis; Transplantation; Transplants & implants; South Korea
• ISSN: 2227-9067; 2227-9067
• DOI: 10.3390/children9101544

Long-term preservation of kidney function after liver transplantation (LT) has not been well studied. We thus evaluated the rates of kidney function preservation and long-term survival after pediatric LT. We also investigated the risk factors associated with the progression of chronic kidney disease (CKD). We conducted a retrospective study of 184 pediatric patients who had undergone LT from 2003 to 2018 at a university hospital. We collected demographics, primary indications for LT, liver disease scores, renal function test results, immunosuppressive drug prescriptions, and diagnosis of post-LT complications. The 15-year survival rate was 90.8%. Furthermore, the rate of kidney function preservation at 14 years post-LT in patients at high risk of renal disease was 79.3%, and that in those with less risk of kidney diseases was 96.0%. Arterial hypertension was an independent risk factor associated with CKD progression. However, when arterial hypertension was excluded, the use of cyclosporine and liver disease with renal involvement were risk factors for CKD progression. We found that kidney function after pediatric LT was well preserved. We encourage the early detection of underlying kidney involvement, routine monitoring of renal function for high-risk patients, active control of hypertension, and appropriate immunosuppressive regimens for pediatric patients with LT.