Reduced impact of renal failure on the outcome of patients with alcoholic liver disease undergoing liver transplantation

Cheong, J.Y.; Galanko, Joseph A.; Arora, Sumant; Cabezas, Joaquín; Ndugga, Nambi; Lucey, Michael R.; Hayashi, Paul H.; Barritt, A. Sidney; Bataller, Ramón

doi:10.1111/liv.13182

Cited by 8 publications

(14 citation statements)

References 31 publications

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“…Our findings are further reinforced by an earlier study using UNOS-STAR data that reported that the presence of pretransplant renal dysfunction was independently associated with lower survival following LT in alcohol-related liver disease and NASH patients. (28) We, however, did not detect any survival difference between the recipients with renal dysfunction before LT and recipients who received SLKT. Similar results have been shown in non-NASH recipients as well.…”

Section: Discussioncontrasting

confidence: 62%

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

et al. 2019

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Nonalcoholic steatohepatitis (NASH) is one of the top 3 indications for liver transplantation (LT) in Western countries. It is unknown whether renal dysfunction at the time of LT has any effect on post-LT outcomes in recipients with NASH. From the United Network for Organ Sharing-Standard Transplant Analysis and Research data set, we identified 4088 NASH recipients who received deceased donor LT. We divided our recipients a priori into 3 categories: group 1 with estimated glomerular filtration rate (eGFR) <30 mL/minute/1.73 m2 at the time of LT and/or received dialysis within 2 weeks preceding LT (n = 937); group 2 with recipients who had eGFR ≥30 mL/minute/1.73 m2 and who did not receive renal replacement therapy prior to LT (n = 2812); and group 3 with recipients who underwent simultaneous liver-kidney transplantation (n = 339). We examined the association of pre-transplant renal dysfunction with death with a functioning graft, all-cause mortality, and graft loss using competing risk regression and Cox proportional hazards models. The mean ± standard deviation age of the cohort at baseline was 58 ± 8 years, 55% were male, 80% were Caucasian, and average exception Model for End-Stage Liver Disease score was 24 ± 9. The median follow-up period was 5 years (median, 1816 days; interquartile range, 1090–2723 days). Compared with group 1 recipients, group 2 recipients had 19% reduced trend for risk for death with a functioning graft (subhazard ratio [SHR], 0.81; 95% confidence interval [CI], 0.64–1.02) and similar risk for graft loss (SHR, 1.25; 95% CI, 0.59–2.62), whereas group 3 recipients had similar risk for death with a functioning graft (SHR, 1.23; 95% CI, 0.96–1.57) and graft loss (SHR, 0.18; 95% CI, 0.02–1.37) using an adjusted competing risk regression model. In conclusion, recipients with preserved renal function before LT showed a trend toward lower risk of death with a functioning graft compared with SLKT recipients and those with pretransplant severe renal dysfunction in patients with NASH.

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Section: Discussioncontrasting

confidence: 62%

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

et al. 2019

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“…Overall, case fatality was 4 out of 35, all of them occurred in the high MELD group. Cause of death was CMV (1), GVHD (1), persistent HRS (1) and sepsis (1).…”

Section: Resultsmentioning

confidence: 99%

“…However, whether the impact of renal failure on patient outcome varies according to the aetiology of the underlying liver disease is largely unknown. 1 Studies on comparative assessment of progressive renal dysfunction pre and post LT are controversial.…”

Section: How To Cite This Articlementioning

confidence: 99%

Prospective Cohort Study of the Renal Outcome in Olt Patients- A Preliminary Observational Study

Narayanan¹,

Balan²,

Patil³

et al. 2017

jebmh

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BACKGROUND Postoperative Acute Renal Injury (ARI) is a serious clinical problem in Orthotopic Liver Transplantation (OLT). There are currently no standard criteria for the evaluation of patients with AKI or Chronic Kidney Disease (CKD) requiring Liver Transplantation (LT). The present study is taken up to fill up the lacunae. What is the use of MELD in predicting the outcome of OLT and renal function?. The aim of our study is to determine the association of various pretransplant risk factors, especially creatinine including the MELD score on patient renal function after OLT.

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“…Although LT has become a standard treatment for acute and chronic end-stage liver disease contributed by NASH, there is not a consensus on the outcomes of the operation. Several separate studies (7)(8)(9)(10)(11) have shown that LT for NASH had increased mortality in early months or years compared to those treated for other indications, while no difference could be observed regarding long-term survival. Moreover, the reason for the shortterm mortality is still unclear.…”

Section: Contextmentioning

confidence: 99%

Outcomes of Non-Alcoholic Steatohepatitis Patients After Liver Transplantation: A Systematic Review and Meta-Analysis

2019

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Context: Non-alcoholic steatohepatitis (NASH) has become a prevalent disease worldwide as well as a leading cause for liver transplantation in the next decades. Thus the purpose of this review is to evaluate the outcomes of NASH patients after liver transplantation in comparison to non-NASH patients. Evidence Acquisition: Studies published in English before February 2018 were retrieved through literature searches in PubMed, Web of Science, Wiley Online Library, Research Gate, and EMBASE. Studies that compared the outcomes of liver transplantation for NASH and other liver diseases were eligible. Results: A total of 13 studies were included in the current study. Compared with non-NASH group, NASH patients presented higher mortality after liver transplantation in 1 and 2 years, which might associate with recipient age, sex, diabetes, and hypertension. However, the 3-and 5-year survival were similar between the two groups. Infection was the most prevalent etiology of mortality in NASH group. Conclusions: The NASH patients receiving liver transplantation presented higher mortality in the first two years and infectious complications were fatal for them. Therefore, more attention should be paid on NASH patients with infections, especially in the first and second year after the transplantation.

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Reduced impact of renal failure on the outcome of patients with alcoholic liver disease undergoing liver transplantation

Cited by 8 publications

References 31 publications

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

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

Prospective Cohort Study of the Renal Outcome in Olt Patients- A Preliminary Observational Study

Outcomes of Non-Alcoholic Steatohepatitis Patients After Liver Transplantation: A Systematic Review and Meta-Analysis

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