Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Jun 27, 2026; 18(6): 119494
Published online Jun 27, 2026. doi: 10.4240/wjgs.119494
Published online Jun 27, 2026. doi: 10.4240/wjgs.119494
Effects of esketamine on perioperative renal injury in paediatric patients undergoing living donor liver transplantation
Hong-Xia Li, Department of Anesthesiology, The First Central Hospital of Tianjin Medical University, Tianjin 300192, China
Gui-Zhu Cao, School of Medicine, Nankai University, Tianjin 300071, China
Yi-Qi Weng, Ai-Li Dong, Min Zhu, Lu Che, Wen-Li Yu, Department of Anaesthesiology, Tianjin First Central Hospital, Tianjin 300192, China
Wei Gao, Department of Hepatic Transplantation, Tianjin First Central Hospital, Tianjin 300192, China
Author contributions: Li HX and Cao GZ designed the research, performed the research, analyzed the data, and wrote the manuscript; Weng YQ, Dong AL, Gao W, Zhu M and Che L collected and organized the data, analyzed the data, and implemented quality control; Yu WL supervised the research and revised the manuscript; all authors have read and approved the final manuscript.
Supported by Research Fund for Liquid Therapy in Anesthesiology Medicine, No. YLGX-MZ-2022008; the Tianjin Key Clinical Specialty (Anaesthesiology) Construction Project; and the Tianjin Key Medical Construction Project, No. TJYXZDXK-3-022C.
Institutional review board statement: The study was approved by the Ethics Committee of the Tianjin First Central Hospital (Approval No. KYAP2025-26).
Clinical trial registration statement: This study is registered at the Chinese Clinical Trial Registry (https://www.chictr.org.cn/index.html). The registration identification number is ChiCTR2500108433.
Informed consent statement: Written informed consent was obtained from the legal guardians of all participants prior to study enrolment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at
Corresponding author: Wen-Li Yu, Department of Anaesthesiology, Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin 300192, China.
Received: January 29, 2026
Revised: March 4, 2026
Accepted: March 25, 2026
Published online: June 27, 2026
Processing time: 143 Days and 15.2 Hours
Revised: March 4, 2026
Accepted: March 25, 2026
Published online: June 27, 2026
Processing time: 143 Days and 15.2 Hours
Core Tip
Core Tip: This randomized controlled trial demonstrates that, compared with the control group, intraoperative esketamine administration significantly attenuates the increase in serum creatinine levels following ischemia-reperfusion injury and attenuates the systemic inflammatory response in pediatric patients undergoing living donor liver transplantation. The renoprotective effects are mediated by the suppression of tumour necrosis factor-α, interleukin-18, and neutrophil gelatinase-associated lipocalin, alongside hemodynamic stabilization. Esketamine may be considered as a component of anesthetic management to mitigate perioperative renal injury in this high-risk population.