*Purpose: The increase in transaminases after kidney transplant (KT) is frequent. Although the cause is unknown, it has been associated with factors such as immunosuppression, infections and cross-talk between liver and kidney in ischemia-reperfusion situations. However, the influence of the type of donor has not been evaluated. We analyze the incidence, relevance and meaning of post-KT hypertransaminasemia.

*Methods: Retrospective study (2004-2018) to analyze the increase in serum AST/ALT during the first 3 months after KT in 119 consecutive KT recipients of deceased donors either brain death (DBD), controlled after cardiac death (cDCD) or uncontrolled after cardiac death (uDCD). All donors received induction with thymoglobulin and maintenance with tacrolimus and mycophenolate.

*Results: Comparing the donor groups, in the uDCD group (n=39) donors and recipients were younger, there were more first transplants and prolonged delayed graft function, although creatinine was similar at 3 months. There were no differences in liver disease history, cold ischemia time, or post-KT hypotension. There were no differences in thymoglobulin induction dose, and uDCD recipients presented lower levels of tacrolimus at one week post-KT. At 72 hours post-KT, 69.2/82.1% of uDCD recipients presented elevation of AST/ALT over the normal values (vs 22/29.3% DBD and 21.1/21.1% cDCD, p<0.001) and 30.8/56.4% presented an elevation of AST/ALT twice over the normal values (vs 6.8/12.1% DBD and 5/5% cDCD, p=0.024/<0.001). This elevation was resolved early, one moth after KT AST/ALT values in all groups were below normal limits (Figure). In the multivariate analysis, donor type was associated with hypertransaminasemia at 72 hours post-KT and, in the uDCD group, hypertransaminasemia was not associated with a prolonged delayed graft function (creatinine decrease> 15 days post-KT).

*Conclusions: Post-transplant hypertransaminasemia is frequent and is associated with the type of kidney donor. This finding is temporary and is not related to a prolonged delayed graft function.

« Back to 2021 American Transplant Congress