End‐stage renal disease after liver transplantation in patients with pre‐transplant chronic kidney disease. (2nd January 2014)

• Record Type: Journal Article
• Authors: Bahirwani, Ranjeeta; Forde, Kimberly A.; Mu, Yifei; Lin, Fred; Reese, Peter; Goldberg, David; Abt, Peter; Reddy, K. Rajender; Levine, Matthew
• Is Part Of: Clinical transplantation. Volume 28:Number 2(2014:Mar./Apr.)
• Page Start: 205
• Page End: 210
• Publication Date: 2014-01-02
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12298
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12298-abs-0001"> <title>Abstract</title> <sec id="ctr12298-sec-0001" sec-type="section"> <p>Renal dysfunction prior to liver transplantation has a marked impact on post‐transplant kidney outcomes.</p> </sec> <sec id="ctr12298-sec-0002" sec-type="section"> <title>Aim</title> <p>The aim of this study was to assess post‐transplant renal function in patients with chronic kidney disease (CKD) receiving orthotopic liver transplantation (OLT) alone.</p> </sec> <sec id="ctr12298-sec-0003" sec-type="section"> <title>Methods</title> <p>Retrospective review of 40 OLT recipients with pre‐transplant CKD (serum creatinine ≥2 mg/dL for at least three months) at the University of Pennsylvania from February 2002 to July 2010. Primary outcome was estimated glomerular filtration rate (eGFR) up to three years post‐transplant. Secondary outcomes included incidence of stage 4 CKD (eGFR < 30 mL/min), need for renal replacement therapy (RRT), meeting criteria for kidney transplant listing (eGFR ≤ 20 mL/min), and mortality.</p> </sec> <sec id="ctr12298-sec-0004" sec-type="section"> <title>Results</title> <p>Median patient age was 56.5 yr and 48% patients had pre‐transplant diabetes. Median serum creatinine at transplant was 2.7 mg/dL (eGFR = 24 mL/min). Median eGFR at one, two, and three yr post‐transplant was 35, 34, and 37 mL/min, respectively. Twelve patients (30%) required RRT at a median of 1.21 yr post‐transplant and 16 (40%) achieved an eGFR ≤ 20 mL/min at 1.09 yr post‐transplant. Mortality was 35% at a median of 1.60 years post‐transplant.</p> </sec> <sec id="ctr12298-sec-0005" sec-type="section"> <title>Conclusions</title> <p>OLT recipients with pre‐transplant CKD have a substantial burden of post‐transplant renal dysfunction and high short‐term mortality, questioning the rationale for OLT alone in this population.</p> </sec> </abstract>