Kidney Volume and Plasma Hepatocyte Growth Factor-Transforming Growth Factor β1 Ratio Among Children With Biliary Atresia Before and After Liver Transplantation: The Reversibility of Nephromegaly

Background: We previously showed a positive correlation between nephromegaly and plasma hepatocyte growth factor (HGF)/transforming growth factor β1 (TGF-β1) ratio in children with biliary atresia. The purpose of this study is to examine the possible reversibility of nephromegaly in patients with biliary atresia. Methods: We evaluated kidney volume in 13 patients with biliary atresia before and after liver transplantation, 6 patients with hepatoblastoma, and 26 healthy children. Plasma HGF and TGF-β1 levels were determined for all children. Results: We noted significant nephromegaly in children with biliary atresia before liver transplantation compared with healthy children and children after liver transplantation (P < 0.001 and P = 0.006 for intercepts, P = 0.064 and P = 0.753 for slopes by analysis of covariance, respectively). The highest plasma HGF levels and HGF/TGF-β1 ratios and the lowest TGF-β1 concentrations were found in children with biliary atresia before liver transplantation (P < 0.001). No statistically significant nephromegaly was observed in children with biliary atresia after liver transplantation or those with hepatoblastoma despite the presence of a mildly increased plasma HGF level and HGF/TGF-β1 ratio. Plasma HGF/TGF-β1 ratio correlated positively with degree of nephromegaly in all patients (r = 0.717; P < 0.001). Conclusion: Our data suggest that liver transplantation reverses the nephromegaly present in children with biliary atresia and that plasma HGF/TGF-β1 ratio may be associated with the development of nephromegaly in patients with biliary atresia.