Analysis of the selected biochemical parameters of liver and kidney function in children of mothers after liver transplantation.
BACKGROUND
Children of mothers after liver transplantation (LT) are exposed during fetal life to the immunosuppressive agents. These drugs may have hepatotoxic and nephrotoxic effects.


OBJECTIVE
The aim of the work was to assess liver and kidney parameters of children born from mothers who had LT.


METHODS
The research included 51 children of mothers after LT and 51 children from a control group who were born in the First Department of Obstetrics and Gynecology in Warsaw between 2001 and 2013. The control group consisted of children born in the similar gestational age. Analysis concerned neonates, infants, and children older than 12 months. Two liver parameters (alanine transaminase [ALT] and aspartate transaminase [AST]) as well as two kidney parameters (urea and creatinine) were assessed. For statistical analysis we used Fisher's exact test and the Mann-Whitney test.


RESULTS
All children from the LT group had correct ALT levels. In the control group, 5 of 51 cases (9.8 %) had levels that were greater than the norm, and those cases concerned only children younger than 12 months. The average concentration of ALT in the LT group was 15.14 U/L and the average for the control group was 22.6 U/L (P = .012699, Mann-Whitney test). Three of 51 children in the LT group (5.9%) and 8 of 51 (15.7%) in the control group had AST levels that were increased (P = .2003; Fisher's exact test). Incorrect AST levels were reported in all age groups. Incorrect values of kidney parameters concerned only neonates. Increased creatinine levels were reported in 3 of 51 cases (5.9%) in the LT group and in 1 of 51 cases (1.96%) in the control group (P = .6175; Fisher's exact test). The average concentration of creatinine in children of mothers after LT was 0.51 mg/dL, and the average of the control group was 0.44 mg/dL (P = .223698; Mann-Whitney test). Only 1 of 51 children in the LT group (1.96%) had an increased urea level. All children from both the LT and the control groups had normal ultrasound images of urinary tract and liver.


CONCLUSIONS
Exposure to immunosuppressive drugs during fetal life does not result in the occurrence of serious disturbances of liver function and kidneys function in children of mothers after LT.
Division of Neonatology, First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland. Electronic address: nczaplinska@gmail.com.
N
N
Czaplińska
Division of Neonatology, First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
B
B
Kociszewska-Najman
Division of Neonatology, First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
J
J
Schreiber-Zamora
Division of Neonatology, First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
E
E
Wilkos
Division of Neonatology, First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
A
A
Drozdowska-Szymczak
Division of Neonatology, First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
B
B
Borek-Dzięcioł
First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
B
B
Pietrzak
First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
M
M
Wielgoś
D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D003404:Creatinine / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000097:blood* / Q000000981:diagnostic imaging; D016031:Liver Transplantation; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood* / Q000000981:diagnostic imaging; D051437:Renal Insufficiency / Q000097:blood* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014551:Urinary Tract / Q000000981:diagnostic imaging
D007166:Immunosuppressive Agents; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase