Conflict of interest: The authors declare no conflicts of interest.
Chronic renal outcome after living donor liver transplantation
Article first published online: 2 SEP 2012
© 2012 John Wiley & Sons A/S
Volume 27, Issue 1, pages 90–97, January–February 2013
How to Cite
Chronic renal outcome after living donor liver transplantation., , , , , , .
- Issue published online: 28 JAN 2013
- Article first published online: 2 SEP 2012
- Manuscript Accepted: 17 JUL 2012
- chronic kidney disease;
- end-stage renal disease;
- living donor liver transplantation
Chronic kidney disease (CKD) is one of the common complications after deceased donor liver transplantation. Although the worldwide pressing shortage in deceased donors has directed attention to living donor liver transplantation (LDLT), LDLT cohort data focusing on chronic renal dysfunction is limited. A total of 280 adult LDLT recipients (median 49 yr, 156 men) at the University of Tokyo hospital between 1996 and 2006 were reviewed. A total of 224 pre-transplant liver failure patients (80.0%) showed an estimated glomerular filtration rate (eGFR) of more than 60 mL/min/1.73 m2. However, during follow-up at a mean of 1222 d after transplantation, eGFR declined to 60 mL/min/1.73 m2 and 30 mL/min/1.73 m2 in 150 (53.2%) and 21 (7.5%), respectively, and four patients (1.4%) required maintenance renal replacement therapy. Multivariate Cox proportional hazard model regression analysis revealed that recipient age (HR, 3.42 per 10-yr increment; p < 0.001) and pre-transplant eGFR (HR, 0.85 per 10-mL/min/1.73 m2 increment; p = 0.04) were associated independently with a post-transplant decrease in eGFR to less than 30 mL/min/1.73 m2. We conclude that higher age and lower pre-transplant eGFR of an LDLT recipient indicate a high likelihood of subsequent development of advanced CKD. Preventive or therapeutic intervention should be optimized for these high-risk patients.