Indian Journal of Transplantation

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 12  |  Issue : 2  |  Page : 90--94

Transient abnormal liver enzyme level in the early stage after renal transplantation in children


Hadas Alfandary, Miriam Davidovits, Amit Dagan 
 Institute of Nephrology, Schneider Children's Medical Center of Israel, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Correspondence Address:
Dr. Amit Dagan
Institute of Nephrology, Schneider Children's Medical Center of Israel, Petach Tikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
Israel

Aim: The study aim was to evaluate the prevalence, risk factors, and clinical importance of abnormal elevation in liver enzyme levels in children after renal transplantation. Materials and Methods: The files of all 62 patients (mean age 10.2 years), who underwent renal transplantation at a tertiary pediatric medical center in 2001-2013, were reviewed for clinical data, including: Postoperative liver function, tacrolimus level, and serology for cytomegalovirus (CMV) and hepatitis B and C viruses. Results: The most common indication for transplantation (53%) was dysplastic hypoplastic kidney. Liver enzyme levels were abnormal in 7 patients (11%) before transplantation and 42 (67.7%) during the first 6 months following, with a peak on day 14 (P < 0.001). Seroconversion was documented during the first post-transplantation year in 9 patients (14.5%), of whom 8 (89%) were CMV IgG negative. Post-transplant abnormal levels were highest in patients who also had abnormally high-level pre-transplant levels (100%), CMV seroconversion (89%), and dysplastic kidney or nephronophthisis (80%). An abnormally elevated liver enzyme level was significantly correlated with high blood tacrolimus level, but only on post-transplant day 3 (P < 0.001). Conclusion: High liver enzyme levels are common in pediatric kidney transplant recipients, usually starting in the first post-transplant month. The etiology is probably multifactorial; drug hepatotoxicity, previous liver injury, and acute viral infection or reactivation are all likely possibilities. About 10-20% of cases are related to CMV infection.


How to cite this article:
Alfandary H, Davidovits M, Dagan A. Transient abnormal liver enzyme level in the early stage after renal transplantation in children.Indian J Transplant 2018;12:90-94


How to cite this URL:
Alfandary H, Davidovits M, Dagan A. Transient abnormal liver enzyme level in the early stage after renal transplantation in children. Indian J Transplant [serial online] 2018 [cited 2022 Oct 7 ];12:90-94
Available from: https://www.ijtonline.in/article.asp?issn=2212-0017;year=2018;volume=12;issue=2;spage=90;epage=94;aulast=Alfandary;type=0