*Purpose: Chronic kidney disease (CKD) is common after liver transplantation (LT) and result worse morbidity and mortality. Hepatitis C virus (HCV) infection is recognized as a risk factor of CKD after LT. The aim of this study was to assess the effect of HCV infection and HCV treatment for kidney function and complications.

*Methods: This is a retrospective study of LT patients who received 1996 to 2013 and survived at least 5 years after LT (n = 41). We compared CKD/End Stage Renal Disease (ESRD) and complications based on HCV infection and its treatment.

*Results: Thirteen patients (31.7%) developed ESRD during the follow-up period (median, 10 years; 5-20 years). HCV cirrhosis, onset of eGFR<30 ml/min/1.73m2, proteinuria, hypertension within 5 years after LT were risk factors for ESRD. The incident of hypertension and cardiovascular disease (CVD) rate were significantly higher among patients who did not achieve sustained virological response (SVR) of HCV within 5 years after LT (Without SVR patients; 10/ All HCV cirrhosis patients: 16), and there were no ESRD patients who achieved SVR within 5 years. Time to crude incident ESRD was also higher in patients without SVR than virus-free recipients (Kaplan-Meier plot, p value:0.05). All patients who developed ESRD without SVR showed nephrotic syndrome without cryoglobulinemia and histology presented various pathophysiology such as membranoproliferative glomerulonephritis, CNI toxicity, and diabetic kidney disease-like glomeruli.

*Conclusions: In LT recipients with chronic HCV infection, achieving SVR early after LT significantly lowers the risk of ESRD and its complication. In order to avoid ESRD after LT, it is important to obtain HCV-free as soon as possible.

« Back to 2019 American Transplant Congress