Mr. Narkewicz et al., Correction of hypozincemia following liver transplantation in children is associated with reduced urinary zinc loss, HEPATOLOGY, 29(3), 1999, pp. 830-833
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.