Dr Kathleen Campbell and colleagues determined the prevalence and risk factors of renal dysfunction in long-term survivors of pediatric liver transplantation.
The investigative team analyzed data from 117 patients who survived 3 or more years after liver transplantation.
The team obtained demographic and clinical information from chart review and from a clinical care database.
|Renal dysfunction was present in 32% about 8 years post-liver transplantation|
|Journal of Pediatrics|
The dependent variable was renal function as determined by measured glomerular filtration rate.
Univariate and multivariate analyses were performed to identify independent variables associated with renal dysfunction.
The investigators noted that the average time since liver transplant was 8 years.
When the last available measured glomerular filtration rate for all patients was analyzed, renal dysfunction was present in 32%.
In the univariate analysis, the team found that measured glomerular filtration rate at 1 year after transplant was a significant risk factor.
The team also found that cyclosporine immunosuppression, and time since transplant were strongly collinear factors.
Using multiple logistic regression modeling excluding time since transplant, cyclosporine was strongly associated with renal dysfunction.
In addition, the team observed that measured glomerular filtration rate at 1 year after transplant was strongly associated with renal dysfunction.
Dr Campbell's team concluded, “Renal dysfunction is a common complication in children who survive liver transplantation.”
“The observations are of critical importance because children may live long enough to move from a stage of renal insufficiency characterized by asymptomatic decreased glomerular filtration rate to symptomatic end-stage renal disease.”