Renal function in the long term after pediatric liver transplantation: Is there a need for protocol kidney biopsies?

Kathleen M. Campbell, John C. Bucuvalas

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Purpose Of Review: With improving survival rates following solid organ transplantation, assessment of its success has broadened with a focus on long-term outcomes, including nongraft-related medical outcomes and family and patient perceptions of quality of life. Posttransplant renal dysfunction contributes to long-term morbidity and mortality following pediatric liver transplantation. In this review, we provide an overview of our understanding and approach to managing posttransplant renal dysfunction and highlight the existing gaps in knowledge in this area. Recent Findings: The literature regarding renal dysfunction following liver transplant primarily focuses on the experience in the adult population. Studies on children are limited by small numbers and varying definitions of outcomes. Thus, lessons in the current literature must be closely examined before they can be extrapolated and applied to children. Summary: The current literature validates that posttransplant renal dysfunction is a frequent and important outcome for adults and children. Although the characteristics of children at high risk are less clear, calcineurin inhibitor minimization is considered a viable strategy for preserving renal function. The risk-benefit ratio of kidney biopsy in children and the possibility of renal preservation via immunosuppression withdrawal are intriguing concepts that remain to be defined.

Original languageEnglish
Pages (from-to)608-613
Number of pages6
JournalCurrent Opinion in Organ Transplantation
Volume15
Issue number5
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • long-term outcomes
  • pediatric liver transplantation
  • renal function

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