Improvement of Renal Function Prior to Liver Transplantation is Not Associated with Better Long-Term Renal Outcome or Mortality
1University Medical Center Hamburg Eppendorf, Hamburg, Germany, 2Department of Medicine, University Medical Center Hamburg Eppendorf, Hamburg, Germany, 3Transplant Surgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany
Meeting: 2020 American Transplant Congress
Abstract number: C-127
Keywords: Kidney/liver transplantation, Liver transplantation, Renal dysfunction, Risk factors
Session Information
Session Name: Poster Session C: Liver - Kidney Issues in Liver Transplantation
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Since introduction of the MELD score in the liver allocation system, renal impairment in OLT recipients has become a topic of increasing importance. This is the first study evaluating the course of renal function prior to OLT as a risk factor for long-term renal outcome and overall survival.
*Methods: All adult patients undergoing OLT at our institution between 2011-2015 were included in this retrospective study. Renal function was assessed over a 3 months period prior to OLT and was associated with long-term renal outcome and patient survival.
*Results: Altogether 226 patients (median age: 60 y) were included in the study. Median follow-up post OLT was 1491 days. Patients were classified according to the nadir GFR value within a period of 3 months prior to OLT (CKD 1: n=30 (13%), CKD 2: n=64 (28%), CKD 3: n=42 (19%), CKD 4: n=42 (19 %) and CKD 5: n=48 (21%)). With respect to the GFR at the day of OLT renal function improved (one CKD stage) in 63 patients (28%), whereas it remained stable or deteriorated in 163 patients (72%). Course of renal function prior to OLT did neither affect 3-month (p=0.9), 1-year (p=0.6) or 5-year patient survival (p=0.4). Also, CKD stage at the end of follow-up post OLT did not significantly differ between patients with and without pre OLT improvement of kidney function (p=0.8). Nevertheless, need for dialysis pre OLT (56% vs. 29%, p<0.05) and need for dialysis post OLT (58% vs. 14%, p<0.05) were both associated with increased 5-year mortality.
*Conclusions: Dialysis pre and postoperatively affected survival in this long-term follow up observational study. However, improvement or worsening of renal function immediately prior to OLT had no significant effect on long-term renal or overall outcome. As alterations of renal function and subsequent changes of the MELD score directly affect prioritization of organ allocation, future studies need to clarify the impact of alterations of serum creatinine on waiting time in patients prior to OLT.
To cite this abstract in AMA style:
Sterneck M, Horvatits T, Touma M, Herden U, Lohse A, Fischer L. Improvement of Renal Function Prior to Liver Transplantation is Not Associated with Better Long-Term Renal Outcome or Mortality [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/improvement-of-renal-function-prior-to-liver-transplantation-is-not-associated-with-better-long-term-renal-outcome-or-mortality/. Accessed May 11, 2025.« Back to 2020 American Transplant Congress