Protecting the Kidney in Liver Transplant Recipients: Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice

Josh Levitsky*, J. G. O'Leary, S. Asrani, P. Sharma, J. Fung, A. Wiseman, C. U. Niemann

*Corresponding author for this work

Research output: Contribution to journalReview article

20 Citations (Scopus)

Abstract

Both acute and chronic kidney disease are common after liver transplantation and result in significant morbidity and mortality. The introduction of the Model for End-stage Liver Disease score has directly correlated with an increased prevalence of perioperative renal dysfunction and the number of simultaneous liver–kidney transplantations performed. Kidney dysfunction in this population is typically multifactorial and related to preexisting conditions, pretransplantation renal injury, perioperative events, and posttransplantation nephrotoxic immunosuppressive therapies. The management of kidney disease after liver transplantation is challenging, as by the time the serum creatinine level is significantly elevated, few interventions affect the course of progression. Also, immunological factors such as antibody-mediated kidney rejection have become of greater interest given the rising liver–kidney transplant population. Therefore, this review, assembled by experts in the field and endorsed by the American Society of Transplantation Liver and Intestine Community of Practice, provides a critical assessment of measures of renal function and interventions aimed at preserving renal function early and late after liver and simultaneous liver–kidney transplantation. Key points and practice-based recommendations for the prevention and management of kidney injury in this population are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.

Original languageEnglish (US)
Pages (from-to)2532-2544
Number of pages13
JournalAmerican Journal of Transplantation
Volume16
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Intestines
Kidney
Liver
Liver Transplantation
Transplantation
Population
Preexisting Condition Coverage
End Stage Liver Disease
Wounds and Injuries
Immunologic Factors
Kidney Diseases
Immunosuppressive Agents
Transplant Recipients
Chronic Renal Insufficiency
Creatinine
Morbidity
Transplants
Mortality
Antibodies
Serum

Keywords

  • clinical research/practice
  • complication: medical/metabolic
  • glomerular filtration rate (GFR)
  • immunosuppression/immune modulation
  • immunosuppressive regimens
  • kidney (native) function/dysfunction
  • kidney transplantation/nephrology
  • liver allograft function/dysfunction
  • liver transplantation/hepatology
  • maintenance
  • translational research/science

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

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title = "Protecting the Kidney in Liver Transplant Recipients: Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice",
abstract = "Both acute and chronic kidney disease are common after liver transplantation and result in significant morbidity and mortality. The introduction of the Model for End-stage Liver Disease score has directly correlated with an increased prevalence of perioperative renal dysfunction and the number of simultaneous liver–kidney transplantations performed. Kidney dysfunction in this population is typically multifactorial and related to preexisting conditions, pretransplantation renal injury, perioperative events, and posttransplantation nephrotoxic immunosuppressive therapies. The management of kidney disease after liver transplantation is challenging, as by the time the serum creatinine level is significantly elevated, few interventions affect the course of progression. Also, immunological factors such as antibody-mediated kidney rejection have become of greater interest given the rising liver–kidney transplant population. Therefore, this review, assembled by experts in the field and endorsed by the American Society of Transplantation Liver and Intestine Community of Practice, provides a critical assessment of measures of renal function and interventions aimed at preserving renal function early and late after liver and simultaneous liver–kidney transplantation. Key points and practice-based recommendations for the prevention and management of kidney injury in this population are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.",
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Protecting the Kidney in Liver Transplant Recipients : Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice. / Levitsky, Josh; O'Leary, J. G.; Asrani, S.; Sharma, P.; Fung, J.; Wiseman, A.; Niemann, C. U.

In: American Journal of Transplantation, Vol. 16, No. 9, 01.09.2016, p. 2532-2544.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Protecting the Kidney in Liver Transplant Recipients

T2 - Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice

AU - Levitsky, Josh

AU - O'Leary, J. G.

AU - Asrani, S.

AU - Sharma, P.

AU - Fung, J.

AU - Wiseman, A.

AU - Niemann, C. U.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Both acute and chronic kidney disease are common after liver transplantation and result in significant morbidity and mortality. The introduction of the Model for End-stage Liver Disease score has directly correlated with an increased prevalence of perioperative renal dysfunction and the number of simultaneous liver–kidney transplantations performed. Kidney dysfunction in this population is typically multifactorial and related to preexisting conditions, pretransplantation renal injury, perioperative events, and posttransplantation nephrotoxic immunosuppressive therapies. The management of kidney disease after liver transplantation is challenging, as by the time the serum creatinine level is significantly elevated, few interventions affect the course of progression. Also, immunological factors such as antibody-mediated kidney rejection have become of greater interest given the rising liver–kidney transplant population. Therefore, this review, assembled by experts in the field and endorsed by the American Society of Transplantation Liver and Intestine Community of Practice, provides a critical assessment of measures of renal function and interventions aimed at preserving renal function early and late after liver and simultaneous liver–kidney transplantation. Key points and practice-based recommendations for the prevention and management of kidney injury in this population are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.

AB - Both acute and chronic kidney disease are common after liver transplantation and result in significant morbidity and mortality. The introduction of the Model for End-stage Liver Disease score has directly correlated with an increased prevalence of perioperative renal dysfunction and the number of simultaneous liver–kidney transplantations performed. Kidney dysfunction in this population is typically multifactorial and related to preexisting conditions, pretransplantation renal injury, perioperative events, and posttransplantation nephrotoxic immunosuppressive therapies. The management of kidney disease after liver transplantation is challenging, as by the time the serum creatinine level is significantly elevated, few interventions affect the course of progression. Also, immunological factors such as antibody-mediated kidney rejection have become of greater interest given the rising liver–kidney transplant population. Therefore, this review, assembled by experts in the field and endorsed by the American Society of Transplantation Liver and Intestine Community of Practice, provides a critical assessment of measures of renal function and interventions aimed at preserving renal function early and late after liver and simultaneous liver–kidney transplantation. Key points and practice-based recommendations for the prevention and management of kidney injury in this population are provided to offer guidance for clinicians and identify gaps in knowledge for future investigations.

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KW - complication: medical/metabolic

KW - glomerular filtration rate (GFR)

KW - immunosuppression/immune modulation

KW - immunosuppressive regimens

KW - kidney (native) function/dysfunction

KW - kidney transplantation/nephrology

KW - liver allograft function/dysfunction

KW - liver transplantation/hepatology

KW - maintenance

KW - translational research/science

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U2 - 10.1111/ajt.13765

DO - 10.1111/ajt.13765

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EP - 2544

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

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