title: Clinicopathologic study of kidney biopsies in patients before or after liver transplant.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the causes of kidney impairment associated with liver transplant in patients who had kidney biopsy before or after liver transplant.
  
  
  METHODS
  In 408 patients who had liver transplant from January 1990 to December 2012, there were 10 patients who had kidney biopsy (total, 19 kidney biopsies) for evaluation of kidney dysfunction. A retrospective review of clinical records and kidney biopsies was performed.
  
  
  RESULTS
  There were 7 male and 3 female patients (median age at liver transplant, 43 y; range, 10 to 62 y). The most frequent reason for liver transplant were hepatitis B virus cirrhosis (4 patients). There were 3 patients who had a kidney transplant before or concurrent with liver transplant. Increased serum creatinine level was the most common clinical finding at the time of kidney biopsy. The median interval from liver transplant to kidney biopsy was 495 days (mean, 1025 d; range, 10-4980 d). The most common pathology in the kidney biopsies was immune complex glomerulonephritis (total, 7 patients: IgA nephropathy, 4 patients; lupus nephritis, 2 patients; membranoproliferative glomerulonephritis, 1 patient). There were 4 patients who had allergic tubulointerstitial nephritis, 2 patients who had chronic calcineurin inhibitor nephrotoxicity, and 1 patient who had karyomegalic nephropathy. There were 7 patients who died at mean 34 months (range, 1-70 mo) after liver transplant. The other 3 patients were alive at mean 128 months (range, 67-193 mo) after liver transplant and had a functioning liver graft and chronic kidney disease.
  
  
  CONCLUSIONS
  Chronic kidney disease after liver transplant has a major effect on mortality. The frequency of immune complex glomerulonephritis associated with liver transplant may be greater than previously recognized.
authors.affiliation: Department of Pathology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ayşen
authors.initials: A
authors.lastname: Terzi
authors.forename: Binnaz Handan
authors.initials: BH
authors.lastname: Özdemir
authors.forename: Firdevs Zeynep
authors.initials: FZ
authors.lastname: Taşlıca
authors.forename: Fatma Nurhan
authors.initials: FN
authors.lastname: Özdemir
authors.forename: Mahir
authors.initials: M
authors.lastname: Kırnap
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D005260:Female; D005921:Glomerulonephritis / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007105:Immune Complex Diseases / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000276:immunology / Q000473:pathology*; D016030:Kidney Transplantation; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents