Association of Pretransplant Renal Function With Liver Graft and Patient Survival After Liver Transplantation in Patients With Nonalcoholic Steatohepatitis

Molnár, Miklós; Joglekar, Kiran; Jiang, Yu; Cholankeril, George; Abdul, Mubeen Khan Mohammed; Kedia, Satish; González, Humberto C.; Ahmed, Aijaz; Singal, Ashwani K.; Bhamidimarri, Kalyan Ram; Aithal, Guruprasad P.; Duseja, Ajay; Wong, Vincent Wai‐Sun; Gulnare, Agayeva; Puri, Puneet; Nair, Satheesh; Eason, James D.

doi:10.1002/lt.25367

Cited by 30 publications

(27 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Donor-related factors such as age, nutritional status, hemodynamic stability during harvesting, and transplant-related factors such as gra preservation, ischemia/reperfusion (I/R) injury have been proposed as common risk factors for PGD. 6,7 Of these, I/R injury occurs unavoidably during the course of liver transplantation and is widely accepted as a major culprit of gra dysfunction, which may lead to organ injury via cytotoxicity and inammation. 6,8 Liver I/R injury is a complex process involving many types of cells and mediators through various pathways.…”

Section: Introductionmentioning

confidence: 99%

Extracellular histones are clinically associated with primary graft dysfunction in human liver transplantation

Gou

Pang

et al. 2019

RSC Adv.

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Extracellular histones are clinically associated with primary graft dysfunction in human liver transplantation

Gou

Pang

et al. 2019

RSC Adv.

View full text Add to dashboard Cite

show abstract

“…This is critical because it is becoming more evident that pre‐LT CKD impacts the risk of both pre‐LT AKI and wait‐list mortality . That being said, although studies have investigated the impact of pre‐LT renal function on post‐LT survival, these studies were limited by subjective definitions of renal failure that did not distinguish between AKI and CKD . Consequently, it is not established if pre‐LT renal function patterns differentially impact post‐LT outcomes.…”

mentioning

confidence: 99%

“…(8,9) That being said, although studies have investigated the impact of pre-LT renal function on post-LT survival, these studies were limited by subjective definitions of renal failure that did not distinguish between AKI and CKD. (10)(11)(12) Consequently, cullarO et al Abbreviations Original article | 499 it is not established if pre-LT renal function patterns differentially impact post-LT outcomes.…”

mentioning

confidence: 99%

Chronic Kidney Disease in Liver Transplant Candidates: A Rising Burden Impacting Post–Liver Transplant Outcomes

et al. 2020

View full text Add to dashboard Cite

The burden of chronic kidney disease (CKD) is rising among patients with cirrhosis, though it is not known what impact this has had on outcomes after liver transplantation (LT). All patients listed for LT in the United States between 2002 and 2017 were analyzed, excluding those listed with Model for End‐Stage Liver Disease (MELD) exceptions. The primary outcome was post‐LT mortality. We defined pre‐LT CKD as an estimated glomerular filtration rate <60 mL/minute for 90 days or ≥42 days of hemodialysis. Cox regression determined the association between pre‐LT CKD and post‐LT mortality. Of 78,640 LT candidates, the proportion with CKD among LT recipients increased from 7.8% in 2002 to 14.6% in 2017 (test for trend, P < 0.001). Among the 39,719 LT recipients, pre‐LT CKD was significantly associated with post‐LT mortality (hazard ratio [HR], 1.16; P < 0.001) even after adjusting for donor risk index (DRI), age, MELD, etiology, hepatic encephalopathy, simultaneous liver‐kidney transplantation (SLKT), and diabetes. There was no mediating influence of SLKT on the effect of pre‐LT CKD on post‐LT survival (P > 0.05). Therefore, pre‐LT CKD has a deleterious impact on post‐LT outcomes, which is an impact that is not mediated through SLKT. These findings highlight the need for the identification of CKD when preventative measures are possible.

show abstract

“…3 Patients waitlisted for NASH have more comorbidities including impaired kidney function. 4 NASH is the most rapidly growing indication for simultaneous liver and kidney transplantation. 5 Post-transplant mortality due to cardiovascular diseases is higher in patients with NASH than other aetiologies.…”

mentioning

confidence: 99%

Liver transplantation for non-alcoholic steatohepatitis in Europe: Where do we stand?

Durand

Pavesi

Cheung

2019

Journal of Hepatology

View full text Add to dashboard Cite

Red flags have recently been raised concerning the growing burden of non-alcoholic steatohepatitis (NASH) in liver transplantation. Interestingly most large studies on NASH in liver transplantation have come from the US for at least two reasons. Firstly, there has been a more rapid increase in the prevalence of obesity and type-2 diabetes mellitus, two major risk factors for non-alcoholic liver disease (NAFLD) and NASH, in the US than in European and Asian countries. 1 The burden of NAFLD/NASH is currently higher in the US than in Europe, as the US has the highest number of obese adults in the world. With the success of direct-acting antivirals, the number of transplantations for hepatitis C virus (HCV) infection has drastically decreased and NASH is now the second most common indication for liver transplantation in the US. 2 Among those on the liver transplant waitlist due to hepatocellular carcinoma (HCC), NASH-related HCC prevalence increased 11.8-fold from 2002 to 2016, the fastest growing cause of HCC. Second, US nationwide data concerning liver transplantation have been prospectively implemented by all transplant centres in the administrative Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) registry since 1988. The OPTN/UNOS dataset allowed for robust epidemiological studies, even if exhaustivity and accuracy of data have been a matter of concern. Standardised collection of data helped analyse trends in liver transplantation in the US. We have learned from the US registry that patients transplanted for NASH are older than patients transplanted for other indications. 3 Patients waitlisted for NASH have more comorbidities including impaired kidney function. 4 NASH is the most rapidly growing indication for simultaneous liver and kidney transplantation. 5 Post-transplant mortality due to cardiovascular diseases is higher in patients with NASH than other aetiologies. 6 Analysis of the OPTN/UNOS registry suggests that post-transplant survival in patients with NASH is not inferior to that in patients transplanted for other chronic liver diseases. 3,7 However, findings in the US may not be directly applicable to Europe. Until now, European data concerning NASH and transplantation have been scarce since no large administrative registry covering all European countries has been published.In this issue, Haldar and colleagues report the results of a large European registry, European Liver Transplant Registry (ELTR) aimed at analysing trends in liver transplantation for NASH throughout 174 transplant centres in 33 European countries. 8 In this study 2,741 patients with NASH (43% with NASH and 57% with presumed NASH) transplanted between 2002 and 2016 were included. The proportion of patients transplanted for NASH increased from 1.2% in 2002 to 8.4% in 2016. Among patients transplanted for NASH, 39.1% had HCC. Post-transplant survival was not significantly different in patients with and without NASH after adjusting for confounding factors. In patients with NASH and no HCC, adva...

show abstract

Association of Pretransplant Renal Function With Liver Graft and Patient Survival After Liver Transplantation in Patients With Nonalcoholic Steatohepatitis

Cited by 30 publications

References 36 publications

Extracellular histones are clinically associated with primary graft dysfunction in human liver transplantation

Extracellular histones are clinically associated with primary graft dysfunction in human liver transplantation

Chronic Kidney Disease in Liver Transplant Candidates: A Rising Burden Impacting Post–Liver Transplant Outcomes

Liver transplantation for non-alcoholic steatohepatitis in Europe: Where do we stand?

Contact Info

Product

Resources

About