Glomerular and tubular function following orthotopic liver transplantation in children treated with tacrolimus

Pediatr Transplant. 2012 May;16(3):250-6. doi: 10.1111/j.1399-3046.2011.01625.x. Epub 2011 Dec 18.

Abstract

The aim of this study was to analyze the impact of TAC on medium term (three-yr follow-up) renal function in pediatric liver transplant (OLT) recipients. Glomerular and tubular indices were retrospectively analyzed in 24 consecutive OLT pediatric recipients on TAC. CrCl increased significantly each month post-OLT (p = 0.003), with a trend toward significance between pre-OLT and 36 months (p = 0.17). There was no correlation between CrCl and TAC troughs (p = 0.783). Sixteen percent of patients had CrCl <60 mL/min/1.73 m(2) pre-OLT vs. none at 36 months post-OLT. TRP values were normal throughout the study. UPr/Cr decreased insignificantly over time and correlated significantly with TAC trough levels (p = 0.031). UCa/Cr values normalized by the third-month post-OLT, decreasing significantly over the time (p = 0.000) but did not correlate with TAC troughs. At three months post-OLT, 65.2% of patients needed antihypertensive therapy, and no patients needed more than one antihypertensive treatment after one yr. Despite nephrotoxic side effects in the early postoperative phase, this study shows that 65.5% patients had a normal renal function by three yr post-OLT. Tubular indices correlated with TAC trough levels.

MeSH terms

  • Adolescent
  • Antihypertensive Agents / pharmacology
  • Child
  • Child, Preschool
  • Chlorides / pharmacology
  • Chromium Compounds / pharmacology
  • Female
  • Humans
  • Immunosuppressive Agents / pharmacology*
  • Infant
  • Kidney Glomerulus / drug effects
  • Kidney Glomerulus / pathology*
  • Kidney Tubules / drug effects
  • Kidney Tubules / pathology*
  • Liver / drug effects
  • Liver Transplantation / methods*
  • Male
  • Retrospective Studies
  • Tacrolimus / pharmacology*
  • Time Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Chlorides
  • Chromium Compounds
  • Immunosuppressive Agents
  • chromous chloride
  • Tacrolimus