Premium
Native kidney function following liver transplantation using calcineurin inhibitors: single‐center analysis with 20 years of follow‐up
Author(s) -
LaMattina John C.,
Mezrich Joshua D.,
Fernandez Luis A.,
D'Alessandro Anthony M.,
Djamali Arjang,
Musat Alexandru I.,
Pirsch John D.,
Foley David P.
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12063
Subject(s) - medicine , calcineurin , immunosuppression , dialysis , transplantation , liver transplantation , regimen , kidney disease , single center , renal function , kidney transplantation , gastroenterology , liver disease , kidney , urology , tacrolimus , surgery
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.