Introduction: Hepatic dysfunction may occurs common in kidney transplant recipients. We aimed to evaluate associated risk factors that affects liver functions in children who underwent kidney transplantation.

Materials and Methods: Eighty-nine renal transplant recipients (F/M:44/45) aged 3-20 years (median: 13) were enrolled the study. Patients with hepatic disfunctions after the first month of the renal transplantation were evaluated retrospectively. Information about age at transplantation, number of transplant, graft survival, deceased or living donor transplant, immunosuppressive drugs, and causes of renal failure, systemic diseases were recorded. Serum electrolytes, kreatinin, AST, ALT, GGT, protombin time, PTT, INR levels and viral markers (hepatitis A, B, C, EBV, CMV, parvovirus) were evaluated. Abnormalities of liver function tests were recorded

Results: Abnormal liver function tests were detected in 38patients (%42.6) . Eighteen of these patients were female and 20 were male. Median age was found as 11 (3-17). Four of these patients had chronic liver disease secondary to hepatic fibrosis, one patient had cystinosis, two patients had glycogen storage disease. When viral markers were evaluated, one patient had positive HBsAg after the transplantation. That patient underwent liver and kidney transplantation because of oxalosis. One patient admitted to hospital because of weakness and vomiting after the fourth year of transplantation and AntiHBcIgM was found positive. Thirty three of 38 patients had positive AntiHBs and 5 had negative AntiHBs. These patients were not able to generate antibodies despite being vaccinated. There was no positive AntiHAV IgM and AntiHCV result. Seven patients had positive EBV-PCR and 4 of them had positive EBV IgM. Eight patients had positive CMV-PCR and 5 of them had positive CMV IgM. Parvovirus hepatitis was detected 2 of the patients during the follow up. Seven patients had drug related hepatic toxicity.

Conclusions: Consequently hepatic dysfunctions in patients who underwent kidney transplantation is a common situation. We found that the causes of the hepatic dysfunctions in these patients are associated with viral infections and drug toxicity. Thus viral markers should be assessed frequently and regularly and these patients need close follow up.