Post-Liver Transplant (LT) Early Allograft Dysfunction (EAD) Modulates the Effect of Pre-LT Kidney Function on Post-LT Survival.

H. Wadei, M. Mai, B. Taner, K. Croome, A. Keaveny, L. Mai, D. Lee.

Transplant, Mayo Clinic, Jackosonville, FL

Meeting: 2017 American Transplant Congress

Abstract number: 427

Keywords: Graft function, Liver transplantation, Renal function

Session Information

Session Name: Concurrent Session: Kidney Issues in Liver Transplantation

Session Type: Concurrent Session

Date: Tuesday, May 2, 2017

Session Time: 2:30pm-4:00pm

Presentation Time: 2:54pm-3:06pm

Location: E451b

The impact of EAD on post-LT renal recovery remains unknown. Aim: To assess the impact of post-LT EAD on renal recovery and post-LT survival. Methods: 1325 1^ry LT recipients were grouped according to pre-LT kidney function into: group A=LT Cr≤1.5mg/dl (n=1093), group B=LT Cr>1.5mg/dl but not on renal replacement therapy (RRT) (n=156) and group C=on RRT (n=76). EAD was defined as at least one of the following:1) POD7 INR ≥1.6, 2) POD 7 bilirubin ≥10mg/dl or 3) ALT or AST ≥2000 IU/ml within 1 week. Renal recovery was defined as freedom from RRT and a Cr <2mg/dl 1 month after LT. Results:Patients' demographics are presented in table 1.

	Group A n=1093	Group B n=156	Group C n=76	P
Age	55±10	59±9	55±10	0.001
% Male	67	75	60	0.06
% Caucasian	91	92	92	0.5
% HCV	39	38	34	0.6
MELD score	17±6	25±8	34±8	0.001
%EAD	27	22	30	0.3
%DCD	13	10	13	0.5
%renal recovery	94	67	78	0.001
1 month Cr	1.1±0.4	1.5±0.6	1.5±0.8	0.001

Group A n=1093 Group B n=156 Group C n=76 P

Age 55±10 59±9 55±10 0.001

% Male 67 75 60 0.06

% Caucasian 91 92 92 0.5

% HCV 39 38 34 0.6

MELD score 17±6 25±8 34±8 0.001

%EAD 27 22 30 0.3

%DCD 13 10 13 0.5

%renal recovery 94 67 78 0.001

1 month Cr 1.1±0.4 1.5±0.6 1.5±0.8 0.001

EAD developed in 358 (27%) patients. Overall, pre-LT kidney function negatively affected post-LT survival Figure 1. When patients were stratified by EAD, pre-LT kidney function impacted post-LT survival only in the EAD group Figure 2A, 2B. 85% EAD vs 92% no-EAD achieved renal recovery at 1 month (P=0.001). Conclusions: 1) Pre-LT kidney function negatively impacts post-LT survival only in patients with post-LT EAD. 2) Post-LT renal recovery is less likely following EAD development. 3) Preventing EAD might be beneficial in improving LT outcome in patients with pre-LT renal dysfunction.

CITATION INFORMATION: Wadei H, Mai M, Taner B, Croome K, Keaveny A, Mai L, Lee D. Post-Liver Transplant (LT) Early Allograft Dysfunction (EAD) Modulates the Effect of Pre-LT Kidney Function on Post-LT Survival. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Wadei H, Mai M, Taner B, Croome K, Keaveny A, Mai L, Lee D. Post-Liver Transplant (LT) Early Allograft Dysfunction (EAD) Modulates the Effect of Pre-LT Kidney Function on Post-LT Survival. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/post-liver-transplant-lt-early-allograft-dysfunction-ead-modulates-the-effect-of-pre-lt-kidney-function-on-post-lt-survival/. Accessed November 21, 2024.

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