Key Points

1. Both acute kidney injury and chronic renal disease are common in patients undergoing liver transplantation. The etiologies are mixed.

2. The incidence of chronic renal failure after liver transplantation is unacceptable, and it has a significant impact on long-term outcomes after liver transplantation.

3. The role of calcineurin inhibitors (CNIs) in the development of posttransplant chronic renal failure is likely overrated.

4. The use of CNIs in the early posttransplant period is currently essential.

5. Whether new agents will be able to provide effective immunosuppression as primary immunosuppressives remains to be proven. Liver Transpl, 2011. © 2011 AASLD.