title: Analysis of liver function test abnormalities in kidney transplant recipients: 7 year experience.
abstract: OBJECTIVE
  Immunosuppressive drugs, antimicrobial agents and infectious complications may cause liver function test abnormalities (LFTA) in kidney transplant recipients (KTR). The objectives of this study were to identify the outcome of (LFTA). To identify the risk factors affecting development and severity of hepatotoxicity in KTR.
  
  
  METHODS
  We retrospectively evaluated the medical records of KTR. Hepatotoxicity attacks were defined as impairment in liver function tests that was responsive to drug dose reduction or discontinuation, or treatment of specific causes such as infectious complications.
  
  
  RESULTS
  One hundred-fifty-six episodes of hepatotoxicity occurred in 107 patients in 281 KTR, with an incidence of 38%. Patients with hepatotoxicity episodes had a high total mortality rate, higher incidence of positive pre-transplant cytomegalovirus (CMV) IgM test, higher creatinine values during the first month post-transplant, underwent additional acute rejection episodes, and received fewer cyclosporin A based ID. Only positive CMV IgM testing was identified as a significant independent risk factor for hepatotoxicity in our multiple analysis. Mycophenolatemofetil (MMF) related hepatotoxicity was the most common cause of drug related LFTA.
  
  
  CONCLUSIONS
  Patients with LFTA can have significant complications. Pre-transplant positive CMV IgM tests predispose transplant recipients to the development of LFTA during the post-transplant period. MMF can be a serious hepatotoxic drug.
authors.affiliation: Oguzhan Sitki Dizdar, Department of Internal Medicine and Clinical Nutrition, Kayseri Training and Research Hospital, Turkey.
authors.forename: Oguzhan Sitki
authors.initials: OS
authors.lastname: Dizdar
authors.affiliation: Alparslan Ersoy, Professor, Department of Internal Medicine, Division of Nephrology, Uludag University Medical School, Turkey.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Ersoy
authors.affiliation: Savas Aksoy, Department of Internal Medicine, Division of Nephrology, Uludag University Medical School, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Aksoy
authors.affiliation: Banu Demet Ozel Coskun, Department of Internal Medicine, Division of Gastroenterology, Kayseri Training and Research Hospital, Turkey.
authors.forename: Banu Demet
authors.initials: BD
authors.lastname: Ozel Coskun
authors.affiliation: Abdulmecit Yildiz, Department of Internal Medicine, Division of Nephrology, Uludag University Medical School, Turkey.
authors.forename: Abdulmecit
authors.initials: A
authors.lastname: Yildiz
keywords: Complication; Cytomegalovirus; Hepatotoxicity; Kidney transplantation; Mycophenolatemofetil