Chronic kidney disease after orthotopic liver transplantation: impact of hepatitis C infection.

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Transplantation. 2011 Jun 15;91(11):1245-9.

Chronic kidney disease after orthotopic liver transplantation: impact of

hepatitis C infection.

Bahirwani R, Shaked O, Kurd S, Bloom R, Reddy KR.

Source

1Division of Gastroenterology and Hepatology, Department of Medicine, Hospital

of the University of Pennsylvania, Philadelphia, PA. 2Department of Medicine,

Hospital of the University of Pennsylvania, Philadelphia, PA. 3Renal,

Electrolyte and Hypertension Division, Hospital of the University of

Pennsylvania, Philadelphia, PA.

Abstract

BACKGROUND.: Hepatitis C virus (HCV) infection has been shown to be a potential

risk factor for the development of chronic kidney disease in liver transplant

recipients. METHODS.: We performed a retrospective cohort study of 307 patients

with and without HCV cirrhosis and preserved pretransplant renal function (serum

creatinine<1.5 mg/dL pretransplantation) to assess the impact of HCV on the

incidence of posttransplant chronic kidney disease. Kaplan-Meier analysis was

performed for time to development of estimated glomerular filtration rate (eGFR)

less than 30 mL/min, need for dialysis, and mortality. RESULTS.: One hundred

eighty-one patients were transplanted for HCV cirrhosis and 126 recipients had

other causes of liver disease. Mean model for end-stage liver disease scores

were 21.64 in the HCV group and 21.30 in the non-HCV group (P=0.58); 51% of

patients in the HCV cohort had hepatocellular carcinoma compared with 27% in the

non-HCV cohort (P<0.001). Mean pretransplant serum creatinine level was 0.89

mg/dL in both groups. At 3 years posttransplant, eGFR did not differ between the

HCV and non-HCV cohorts (64.96 mL/min vs. 66.09 mL/min; P=0.71). A total of

14.4% of the patients with HCV achieved an eGFR less than 30 mL/min compared

with 10.3% of the patients without HCV (P=0.13). There was no difference between

the cohorts with respect to requirement for dialysis (P=0.73) or deaths

(P=0.08), including those that were liver related (P=0.15). CONCLUSIONS.:

Patients with HCV cirrhosis and normal preliver transplant renal function do not

have worse posttransplant renal outcomes compared with those with other causes

of liver disease.

PMID: 21617587 [PubMed - in process]