Early Allograft Dysfunction after Liver Transplantation Is Associated with Short- and Long-Term Kidney Function Impairment

H. M. Wadei, D. D. Lee, K. P. Croome, Martin Mai, E. Golan, R. Brotman, A. P. Keaveny, C. B. Taner

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Early allograft dysfunction (EAD) after liver transplantation (LT) is related to ischemia-reperfusion injury and may lead to a systemic inflammatory response and extrahepatic organ dysfunction. We evaluated the effect of EAD on new-onset acute kidney injury (AKI) requiring renal replacement therapy within the first month and end-stage renal disease (ESRD) within the first year post-LT in 1325 primary LT recipients. EAD developed in 358 (27%) of recipients. Seventy-one (5.6%) recipients developed AKI and 38 (2.9%) developed ESRD. Compared with those without EAD, recipients with EAD had a higher risk of AKI and ESRD (4% vs. 9% and 2% vs. 6%, respectively, p < 0.001 for both). Multivariate logistic regression analysis showed an independent relationship between EAD and AKI as well as ESRD (odds ratio 3.5, 95% confidence interval 1.9-6.4, and odds ratio 3.1, 95% confidence interval 11.9-91.2, respectively). Patients who experienced both EAD and AKI had inferior 1-, 3-, 5-, and 10-year patient and graft survival compared with those with either EAD or AKI alone, while those who had neither AKI nor EAD had the best outcomes (p < 0.001). Post-LT EAD is a risk factor for both AKI and ESRD and should be considered a target for future intervention to reduce post-LT short- and long-term renal dysfunction. In this study of 1325 primary liver transplant recipients, the authors identify a link between early liver allograft dysfunction and new onset acute kidney injury within one month and end-stage renal disease at one year after liver transplantation.

Original languageEnglish (US)
Pages (from-to)850-859
Number of pages10
JournalAmerican Journal of Transplantation
Volume16
Issue number3
DOIs
StatePublished - Mar 1 2016

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Liver Transplantation
Allografts
Acute Kidney Injury
Kidney
Chronic Kidney Failure
Odds Ratio
Confidence Intervals
Renal Replacement Therapy
Graft Survival
Reperfusion Injury
Liver Diseases
Logistic Models
Regression Analysis
Liver

ASJC Scopus subject areas

  • Immunology and Allergy
  • Medicine(all)
  • Pharmacology (medical)
  • Transplantation

Cite this

Early Allograft Dysfunction after Liver Transplantation Is Associated with Short- and Long-Term Kidney Function Impairment. / Wadei, H. M.; Lee, D. D.; Croome, K. P.; Mai, Martin; Golan, E.; Brotman, R.; Keaveny, A. P.; Taner, C. B.

In: American Journal of Transplantation, Vol. 16, No. 3, 01.03.2016, p. 850-859.

Research output: Contribution to journalArticle

Wadei, H. M. ; Lee, D. D. ; Croome, K. P. ; Mai, Martin ; Golan, E. ; Brotman, R. ; Keaveny, A. P. ; Taner, C. B. / Early Allograft Dysfunction after Liver Transplantation Is Associated with Short- and Long-Term Kidney Function Impairment. In: American Journal of Transplantation. 2016 ; Vol. 16, No. 3. pp. 850-859.
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