INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: H J Schlitt; A Barkmann; K H Böker; H H Schmidt; N Emmanouilidis; J Rosenau; M J Bahr; G Tusch; M P Manns; B Nashan; J Klempnauer Journal: Lancet Date: 2001-02-24 Impact factor: 79.321
Authors: Ergun Velidedeoglu; Roy D Bloom; Michael D Crawford; Niraj M Desai; Luis Campos; Peter L Abt; Joseph W Markmann; Kevin C Mange; Kim M Olthoff; Abraham Shaked; James F Markmann Journal: Transplantation Date: 2004-02-27 Impact factor: 4.939
Authors: A Amore; R Coppo; D Roccatello; G Piccoli; G Mazzucco; M Gomez-Chiarri; M E Lamm; S N Emancipator Journal: Lab Invest Date: 1994-01 Impact factor: 5.662
Authors: Maria Luisa Raimondo; Lucy Dagher; George V Papatheodoridis; Nancy Rolando; David W Patch; Brian R Davidson; Keith Rolles; Andrew K Burroughs Journal: Transplantation Date: 2003-01-27 Impact factor: 4.939
Authors: K P Platz; A R Mueller; G Blumhardt; S Bachmann; W O Bechstein; A Kahl; P Neuhaus Journal: Transplantation Date: 1994-07-27 Impact factor: 4.939
Authors: Akinlolu O Ojo; Philip J Held; Friedrich K Port; Robert A Wolfe; Alan B Leichtman; Eric W Young; Julie Arndorfer; Laura Christensen; Robert M Merion Journal: N Engl J Med Date: 2003-09-04 Impact factor: 91.245
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Authors: M Sterneck; G M Kaiser; N Heyne; N Richter; F Rauchfuss; A Pascher; P Schemmer; L Fischer; C G Klein; S Nadalin; F Lehner; U Settmacher; P Neuhaus; D Gotthardt; M Loss; S Ladenburger; E M Paulus; M Mertens; H J Schlitt Journal: Am J Transplant Date: 2014-02-06 Impact factor: 8.086