Effects of esketamine on perioperative renal injury in paediatric patients undergoing living donor liver transplantation

doi:10.4240/wjgs.119494

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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

Table 1 Comparison of general characteristics between paediatric groups

Parameter	Group E (n = 30)	Group C (n = 30)	P value
Age (months)	7.56 (6.44-9.09)	8.26 (6.80-10.09)	0.091
Weight (kg)	7.05 ± 0.44	7.18 ± 0.52	0.206
Height (cm)	65.45 ± 5.09	66.38 ± 7.02	0.426
PELD score	16.09 ± 3.40	17.10 ± 3.43	0.055
ASA (II/III)	18/12	17/13	0.586
Preoperative Scr level (μmol/L)	16.88 ± 6.02	17.71 ± 5.42	0.527
Blood loss (mL)	158.02 ± 32.12	155.17 ± 27.21	0.656
Urine output (mL)	455.50 ± 62.46	446.28 ± 59.75	0.494
Infusion volume (mL)	1620.63 ± 443.41	1478.73 ± 510.38	0.255
Blood transfusion volume (units)	3.00 (2.00, 4.00)	2.00 (2.00, 3.76)	0.175
Plasma transfusion volume (mL)	400 (225-400)	400 (200-415)	0.680
Ascites-free period (minute)	41.32 ± 12.53	43.54 ± 14.23	0.596
Surgical time (hour)	8.60 ± 1.20	8.80 ± 1.03	0.361
Anaesthesia duration (hour)	10.12 ± 1.21	9.80 ± 1.06	0.734

Data were showed as median (interquartile range) or mean ± SD. PELD: Paediatric end-stage liver disease; ASA: American Society of Anesthesiologists; Scr: Serum creatinine.

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Table 2 Comparison of serum creatinine levels and acute kidney injury incidence between groups

Time	Group E Scr (μmol/L)	Group C Scr (μmol/L)	P value	Cohen's d
T1	18.84 ± 6.11	20.78 ± 5.67	0.207	-0.329
T2	22.26 ± 7.05	22.59 ± 6.85	0.855	-0.047
T3	40.56 ± 15.4^a^,^b	60.37 ± 15.4^b	< 0.05	-1.286
T4	36.35 ± 8.96^a^,^b	58.93 ± 12.57^b	< 0.05	-2.069
T5	34.64 ± 5.66^a^,^b	53.51 ± 8.69^b	< 0.05	-2.573
AKI	11 (36.7)	15 (50.0)	0.435	-

^aP < 0.05 vs group C.

^bP < 0.05 vs T1.

Data were showed as n (%) or mean ± SD. T1: 5 minutes after anaesthetic induction; T2: 30 minutes during the anhepatic phase; T3: 3 hours during the new liver phase; T4: 24 hours postoperatively; T5: 72 hours postoperatively. Scr: Serum creatinine; AKI: Acute kidney injury.

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Table 3 Comparison of mean arterial pressure, heart rate, and central venous pressure between the two groups of paediatric patients

	Group E			Group C
	MAP (mmHg)	HR (beats/minute)	CVP (mmHg)	MAP (mmHg)	HR (beats/minute)	CVP (mmHg)
T1	55 ± 3.1	119 ± 12	6.4 ± 2.5	54 ± 3.7	126 ± 13	6.9 ± 2.2
T2	44 ± 2.8^a^,^b	128 ± 17	5.2 ± 2.3	34 ± 2.6^b	131 ± 16	5.4 ± 3.5
T3	42 ± 2.5^a^,^b	105 ± 16	8.3 ± 2.0	32 ± 2.7^b	108 ± 17	8.9 ± 2.8
T4	48 ± 4.8	120 ± 16	9.5 ± 3.4	47 ± 3.8	114 ± 15	8.6 ± 3.0
T5	55 ± 5.1	118 ± 13	8.7 ± 2.6	53 ± 5.4	122 ± 17	8.5 ± 3.2

^aP < 0.05 vs group C.

^bP < 0.05 vs T1.

T1: 5 minutes after anaesthetic induction; T2: 30 minutes during the anhepatic phase; T3: 3 hours during the new liver phase; T4: 24 hours postoperatively; T5: 72 hours postoperatively. MAP: Mean arterial pressure; HR: Heart rate; CVP: Central venous pressure.

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Table 4 Comparison of interleukin-10, interleukin-18, neutrophil gelatinase-associated lipocalin and tumour necrosis factor-α levels at different time points between the two groups

	Group E				Group C
	IL-10 (pg/mL)	IL-18 (pg/mL)	NGAL (ng/mL)	TNF-α (pg/mL)	IL-10 (pg/mL)	IL-18 (pg/mL)	NGAL (ng/mL)	TNF-α (pg/mL)
T1	89.74 ± 20.32	86.30 ± 15.30	23.45 ± 5.29	80.65 ± 13.80	90.91 ± 16.63	92.32 ± 15.41	25.14 ± 5.37	89.73 ± 16.45
T2	94.23 ± 22.21	123.34 ± 32.44^a^,^b	38.15 ± 6.17^a^,^b	129.50 ± 26.63^a^,^b	91.27 ± 20.33	168.50 ± 35.60^b	60.53 ± 5.46^b	163.76 ± 31.26^b
T3	93.78 ± 19.25	145.55 ± 34.47^a^,^b	62.16 ± 8.39^a^,^b	147.62 ± 32.12^a^,^b	93.48 ± 21.33	191.27 ± 39.92^b	102.22 ± 6.77^b	199.22 ± 29.43^b
T4	90.23 ± 21.21	122.51 ± 23.76^a^,^b	35.54 ± 5.26^a^,^b	130.90 ± 25.51^a^,^b	94.21 ± 22.56	150.33 ± 25.37^b	96.32 ± 5.54^b	172.30 ± 29.43^b
T5	92.31 ± 30.21	108.26 ± 22.90^a^,^b	34.65 ± 8.19^a^,^b	97.23 ± 23.45^a^,^b	93.32 ± 26.54	141.32 ± 22.43^b	71.43 ± 6.18^b	156.29 ± 26.65^b

^aP < 0.05 vs group C.

^bP < 0.05 vs T1.

T1: 5 minutes after anaesthetic induction; T2: 30 minutes during the anhepatic phase; T3: 3 hours during the new liver phase; T4: 24 hours postoperatively; T5: 72 hours postoperatively. IL: Interleukin; NGAL: Neutrophil gelatinase-associated lipocalin; TNF-α: Tumour necrosis factor-α.

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Table 5 Comparison of hospitalisation duration, extubation time, and intensive care unit stay between groups

Parameter	Group E	Group C	P value
Tube withdrawal time (minute)	168.55 ± 69.64	264.55 ± 73.64	< 0.001
Hospitalisation duration (day)	23.25 ± 5.44	24.29 ± 5.52	0.268
ICU stay duration (day)	3.25 ± 0.84	3.58 ± 1.22	0.087

ICU: Intensive care unit.

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Citation: Li HX, Cao GZ, Weng YQ, Dong AL, Gao W, Zhu M, Che L, Yu WL. Effects of esketamine on perioperative renal injury in paediatric patients undergoing living donor liver transplantation. World J Gastrointest Surg 2026; 18(6): 119494
URL: https://www.wjgnet.com/1948-9366/full/v18/i6/119494.htm
DOI: https://dx.doi.org/10.4240/wjgs.119494

Li HX, Cao GZ, Weng YQ, Dong AL, Gao W, Zhu M, Che L, Yu WL. Effects of esketamine on perioperative renal injury in paediatric patients undergoing living donor liver transplantation. World J Gastrointest Surg 2026; 18(6): 119494 [DOI: 10.4240/wjgs.119494]

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