*Purpose: Renal dysfunction post solid organ transplantation is common and associated with several risk factors. Messenger RNA encoding for genes expressed along the nephron and released into the urine may represent suitable non-invasive candidate biomarkers for renal injury in liver transplant (LT) patients.

*Methods: Patients/Methods: The study included urine samples from 82 LT patients under Tacrolimus-based maintenance immunosuppression, comparing patients with clinically suspected renal dysfunction (LT-RD) to those with stable renal function (LT-N) at follow up visits. Urine samples from 22 non-transplanted patients diagnosed with acute kidney injury (AKI) were used as a control group. A urinary gene panel was tested using real time quantitative PCR. Pairwise comparisons for each gene were performed using two-sample t-test.

*Results: Results: Several genes including SLC13A3, AQP1, AQP2, NPHS2, CUBN, LRP2, and SLC12A3 among others were differentially expressed between LT-RD and LT-N patients. Compared to the AKI group, the LT-RD group also demonstrated different expression levels of LCN2, AQP2, CUBN, LPR2, SLC13A3 and LGALS1. From the evaluation of diagnostic performance, the gene expression panel was able to classified LT-RD with 70% sensitivity and 83% specificity.

*Conclusions: Conclusion: This study identified a differentially expressed panel of genes, which may serve as urinary biomarkers for renal dysfunction on LT patients with CNI based immunosuppression.

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