Long-Term Renal Function in Children After Liver Transplantation

Kivelä, Jesper M.; Räisänen-Sokolowski, Anne; Pakarinen, Mikko P.; Mäkisalo, Heikki; Jalanko, Hannu; Holmberg, Christer; Lauronen, Jouni

doi:10.1097/tp.0b013e3181fa94b9

Cited by 48 publications

(57 citation statements)

References 31 publications

(35 reference statements)

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“…As previously shown (23,24), the bedside Schwartz formula overestimated the GFR by 10% on average. This is in agreement with a report by Tsampalieros et al (23), who found that in kidney transplant recipients the bedside Schwartz formula overestimated the mGFR by 9%.…”

Section: Discussionsupporting

confidence: 54%

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Souza¹,

Cochat²,

Rabilloud³

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objective The knowledge of renal function is crucial for the management of pediatric kidney transplant recipients. In this population, the most commonly used plasma creatinine (PCr)-based or cystatin C (CystC)-based GFR-predicting formulas may underperform (e.g., corticosteroids and trimethoprim may affect PCr concentration, whereas prednisone and calcineurin inhibitors may affect CystC concentration). This study evaluated the performance of six formulas in pediatric kidney transplant recipients.Design, setting, participants, & measurements The study used PCr-based formulas (bedside Schwartz, SchwartzLyon), CystC-based formulas (Hoek, Filler), and combined PCr-CystC-based formulas (CKD in Children [CKiD] 2012 and Zappitelli). The performance of these formulas was compared using inulin clearance as reference and assessed according to CKD stages in a historical cohort that included 73 pediatric kidney transplant recipients (199 measurements). The ability of the formulas to identify GFRs,60, ,75, and ,90 ml/min per 1.73 m 2 was assessed.Results At measured GFR (mGFR) $90 ml/min per 1.73 m 2 (nine patients; 23 measurements), the Zappitelli formula had the highest 30% accuracy (P30) (95% [95% confidence interval (95% CI), 87% to 100%]) and the bedside Schwartz had the highest 10% accuracy (P10) (56% [95% CI, 32% to 72%]). At mGFR$60 and ,90 ml/min per 1.73 m 2 (22 patients; 91 measurements), all formulas had P30 values .80%. However, only the CKiD 2012 formula had a P10 value .50%. At mGFR,60 ml/min per 1.73 m 2 (42 patients; 85 measurements), the CKiD 2012 and Schwartz-Lyon formulas had the highest P10 (45% [95% CI, 34% to 55%] and 43% [95% CI, 33% to 54%]) and P30 (90% [95% CI, 84% to 97%] and 91% [95% CI, 86% to 98%]). All studied equations except Hoek and Filler had areas under the receiver-operating characteristic curves significantly .90% in discriminating patients with renal dysfunction at various CKD stages (GFR,60, ,75, and ,90 ml/min per 1.73 m 2 ).Conclusions In pediatric kidney transplant recipients, the CKiD 2012 formula had the best performance at mGFRs,90 ml/min per 1.73 m 2 . CystC-based formulas were not superior to PCr-based formulas.

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Section: Discussionsupporting

confidence: 54%

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Souza¹,

Cochat²,

Rabilloud³

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…The complications of long-term use of immunosuppression are-among others-nephrotoxicity and cancer risk. Chronic kidney disease was found in 25% to 30% at 10 years after OLT [34,35]. The use of newer and less nephrotoxic immunosuppressive agents such as tacrolimus might be associated with better long-term kidney function, although the long-term evaluation of the randomized European trial of cyclosporin vs tacrolimus in pediatric OLT revealed no difference between both groups [36,37].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation in the treatment of liver tumors in children

Laarhoven

Baren

Tamminga³

et al. 2012

Journal of Pediatric Surgery

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“…However, availability of high quality donor livers for hepatocyte isolation is limited. Furthermore, transplantation of allogeneic hepatocytes does not bypass the need for long-term immunotherapy, which is by itself one important factor in the reduced life expectancy of PH1 patients (Cibrik et al 2002;Kivelä et al 2011). Consequently, current efforts are targeted at the potential use of hepatocytes generated from iPSCs derived from individual patients as vehicles for ex vivo gene therapy using autologous cells (Zapata-Linares et al 2016), so that the need for immunosuppression can be circumvented.…”

Section: Cell Therapymentioning

confidence: 97%

Molecular therapy of primary hyperoxaluria

Martín-Higueras

Torres

Salido

2017

J of Inher Metab Disea

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During the last few decades, the molecular understanding of the mechanisms involved in primary hyperoxalurias (PHs) has set the stage for novel therapeutic approaches. The availability of PH mouse models has facilitated preclinical studies testing innovative treatments. PHs are autosomal recessive diseases where the enzymatic deficit plays a central pathogenic role. Thus, molecular therapies aimed at restoring such deficit or limiting the consequences of the metabolic derangement could be envisioned, keeping in mind the specific challenges posed by the cell-autonomous nature of the deficiency. Various molecular approaches like enzyme replacement, substrate reduction, pharmacologic chaperones, and gene and cell therapies have been explored in cells and mouse models of disease. Some of these proof-of-concept studies have paved the way to current clinical trials on PH type 1, raising hopes that much needed treatments will become available for this severe inborn error of metabolism.

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Long-Term Renal Function in Children After Liver Transplantation

Abstract: This study underlines the importance of long-term renal function surveillance after LT performed on children. Although measuring GFR remains the preferred function surveillance method, the updated Schwartz formula is also acceptable.

Cited by 48 publications

References 31 publications

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Radiofrequency ablation in the treatment of liver tumors in children

Molecular therapy of primary hyperoxaluria

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