Correction of hypozincemia following liver transplantation in children is associated with reduced urinary zinc loss

Zinc deficiency is a relatively common problem in children with chronic liv er disease. We have previously shown inappropriate urinary zinc excretion i n children with chronic liver disease and hypozincemia. This study was desi gned to determine if zinc deficiency and inappropriate urinary zinc losses are corrected in children with liver disease by liver transplantation. Thir ty-three patients (age 1-19 years) underwent 35 liver transplants for acute and chronic liver disease. At the time of transplant, 17 patients had low plasma zinc (hypozincemic) (plasma zinc, 45.4 +/- 1.8 mu g/dL), whereas 18 had normal plasma zinc (75.7 +/- 3.8). Before transplant, patients with zin c deficiency had higher urinary zinc to creatinine ratio compared with thos e with normal zinc status (6.6 +/- 1.9 vs. 2.2 +/- 0.6; P =.03) and lower s erum albumin concentrations (low: 2.8 +/- 0.1 vs. normal: 3.3 +/- 0.2; P =. 02). After transplant, there was a significant reduction in urinary zinc lo sses in the hypozincemic group followed by normalization of plasma zinc lev els by 7 days posttransplant, These data suggest that the abnormal renal zi nc homeostasis that is present in approximately 50% of pediatric patients u ndergoing liver transplant is rapidly improved and biochemical zinc deficie ncy is reversed after liver transplantation.