Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: It is unknown whether severity of renal dysfunction in ACLF patients impacts outcome of ACLF patients compared to those without ACLF.
*Methods: In a single center large retrospective study, we included 413 of 687 consecutive LT recipients. Recipients were analyzed in 3 groups: ACLF with Low GFR (A-LGFR) at LT (eGFR<30 mL/min;n=27); ACLF with High GFR(A-HGFR) (eGFR ≥30 mL/min;n=32); and those with no ACLF(n =354). The longitudinal data set with eGFR at transplant(0) and 3,4,5,6,7,8,9,12 months post-LT were evaluated. We assessed the association between ACLF and three kidney related outcomes:1) eGFR at baseline and 12 months,2) time to development of composite kidney outcome(eGFR<30 mL/min separated by ≥90 days or need for dialysis), and 3)association of pretransplant renal dysfunction(eGFR closet to LT) with the slope of renal function after LT by linear mixed model.
*Results: Mean age at LT was 54±9 years, 32% were female and 75% were Caucasian. Figure represents the eGFR over time by group with mean eGFR over time (red line).
A change in the slope for eGFR at 3 months after LT was noted in all three groups, with a decline in the non-ACLF group, and a statistically significant increase in the A-LGFR and the A-HGFR group(p<0.0001). After 3 months, eGFR in the LGFR group approached the baseline mean eGFR value of A-HGFR and non-ACLF groups. The difference between the eGFR slope before 3 months and after 3 months was significant in non-ACLF and A-LGFR groups (p<0.0001), but not in the A-HGFR group after adjusting for confounders.EGFR at LT (4±29 vs 84±29 ml/min, p<0.001), 3 months after LT (54±29 vs 65±26 ml/min, p<0.001), and 12 months (59±23 vs 71±24 ml/min, p=0.001) were significantly lower in the ACLF group compared to non-ACLF group.
*Conclusions: Patients with ACLF have significantly lower eGFRs at 12 months follow up compared to the non-ACLF group. However, the trajectory of eGFR slope and time to composite kidney outcome were not different at 12 months.
To cite this abstract in AMA style:Yazawa M, Maliakkal B, Nair S, Jiang Y, Podila PS, Agbim UA, Karri S, Khan SD, Maluf D, Eason JD, Molnar MZ, Satapathy SK. Post-Transplant Renal Function in ACLF Patients Based on Pre-Transplant Severity of Renal Dysfunction without Kidney Transplant [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/post-transplant-renal-function-in-aclf-patients-based-on-pre-transplant-severity-of-renal-dysfunction-without-kidney-transplant/. Accessed December 1, 2023.
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