Post-Liver Transplant (LT) Early Allograft Dysfunction (EAD) Modulates the Effect of Pre-LT Kidney Function on Post-LT Survival.
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 1ry 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 |
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 December 5, 2024.« Back to 2017 American Transplant Congress