title: A single-center analysis to evaluate kidney function parameters after liver transplantation in adult patients.
abstract: Severe renal dysfunction may occur after orthotopic liver transplantation (OLT). In this study, we retrospectively analyzed a single-center series of adult liver recipients (n = 62) seeking to identify patients prone to develop renal dysfunction during follow-up. Liver recipients (age range, 53.54 ± 8.19 years; female/male: 21/41) who underwent a first OLT from a brain dead donor were enrolled according to strict criteria. We enrolled only liver recipients with 5 serum creatinine (SCr) measurements after hospital discharge and at least 1 measurement/year with a follow-up period of not less than 2 years. We estimated glomerular filtration rate (eGFR) using the formula developed by the Mayo Clinic. The average rate of SCr change after OLT was 0.0065 ± 0.013 mg/dL/mo. By calculating the per-patient slope, the average rate of SCr change was 0.000165 ± 0.000383 mg/dL (0.000007 ± 0.000017 mg/dL/mo). In regression models evaluated with SCr as the dependent variable versus post-OLT time, no significance was observed (P = .130). The average rate of eGFR change after OLT was -0.462 ± 0.883 mL/min/mo. By calculating the per-patient slope, the average rate of eGFR change was -0.009 ± 0.0026 mL/min (-0.0004 ± 0.0012 mL/min/mo). In the regression models evaluated with eGFR as dependent variable versus post-OLT time, no significance occurred (P = .168). By applying the regression prediction to SCr at 3 to 5 versus the 1 to 2 post-OLT measurements, we noted 3 male liver recipients (MLR) whose SCr values were significantly higher than the predicted values: MLR1: P = .048 at measurement 4; MLR2: P = .019 at measurement 4; and MLR3: P = .017 at measurement 5. Conversely, we did not observed a significant difference between observed versus predicted eGFR values. Clinical decisions on immunosuppressive treatments for liver recipients should be determined also on the basis of the series of post-OLT kidney function, which should be studied with rigorous evaluation of fitted regression models.
authors.affiliation: Department of Surgical Sciences and Integrated Diagnostics (DISC), Organ Transplantation Section, University of Genoa, Italy. gregorio.santori@gmail.com
authors.forename: G
authors.initials: G
authors.lastname: Santori
authors.forename: I
authors.initials: I
authors.lastname: Fontana
authors.forename: N
authors.initials: N
authors.lastname: Morelli
authors.forename: M
authors.initials: M
authors.lastname: Casaccia
authors.forename: S
authors.initials: S
authors.lastname: Di Domenico
authors.forename: G
authors.initials: G
authors.lastname: Varotti
authors.forename: A
authors.initials: A
authors.lastname: Nocera
authors.forename: U
authors.initials: U
authors.lastname: Valente
mesh_terms: D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged