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

26 Scopus citations

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

ASJC Scopus subject areas

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

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