Native kidney function following liver transplantation using calcineurin inhibitors: single‐center analysis with 20 years of follow‐up. (7th January 2013)

• Record Type: Journal Article
• Authors: LaMattina, John C.; Mezrich, Joshua D.; Fernandez, Luis A.; D'Alessandro, Anthony M.; Djamali, Arjang; Musat, Alexandru I.; Pirsch, John D.; Foley, David P.
• Is Part Of: Clinical transplantation. Volume 27:Number 2(2013:Mar./Apr.)
• Page Start: 193
• Page End: 202
• Publication Date: 2013-01-07
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12063
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12063-abs-0001"> <title>Abstract</title> <sec id="ctr12063-sec-0001" sec-type="section"> <title>Introduction</title> <p>The incidence of chronic kidney disease (CKD) in liver transplant recipients has been estimated to be from 18% to 28% at 10 yr after transplantation. As outcomes from liver transplantation continue to improve, long‐term native kidney function in these recipients becomes more critical to patient survival.</p> </sec> <sec id="ctr12063-sec-0002" sec-type="section"> <title>Methods</title> <p>We analyzed 1151 adult, deceased‐donor, single‐organ primary liver transplantations performed at our center between 7/17/84 and 12/31/07. Analysis of renal function was performed on 972 patients with liver allograft survival >1 yr.</p> </sec> <sec id="ctr12063-sec-0003" sec-type="section"> <title>Results</title> <p>Kaplan–Meier analysis revealed that 3%, 7%, and 18% of liver transplant recipients with allograft survival >1 yr developed end‐stage renal disease (ESRD) at five, 10, and 20 yr, respectively. Significant independent risk factors for ESRD included dialysis during the transplant hospitalization, the stage of CKD at one yr, hypercholesterolemia, non‐Caucasian race, and hepatitis C as the primary indication for liver transplantation. The initial immunosuppression of essentially all recipients was a calcineurin inhibitor‐based regimen.</p> </sec> <sec id="ctr12063-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Close, long‐term follow‐up of liver transplant recipients permits optimal management of liver allograft and native renal function and can lead to excellent long‐term outcomes despite a calcineurin inhibitor‐based immunosuppressive regimen.</p> </sec> </abstract>