Predictive Factors for Chronic Renal Failure One Year after Orthotopic Liver Transplantation

Author： Guitard Joelle Ribes David Kamar Nassim Muscari Fabrice Cointault Olivier Lavayssière Laurence Suc Bertrand Esposito Laure Peron Jean-Marie Rostaing Lionel

Publisher： Informa Healthcare

ISSN： 0886-022X

Source： Renal Failure, Vol.28, Iss.5, 2006-06, pp. : 419-425

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Abstract

Chronic renal failure (CRF) is increasingly prevalent in solid-organ-transplant patients. This is in part related to the long-term use of calcineurin inhibitor (CNI) agents. However, in orthotopic liver-transplant (OLT) patients, the effects of superimposed hepatitis C virus (HCV)-related renal lesions could also be a factor. The aim of this cohort study (February 2000 to September, 2003) was to identify the predictive factors at one year post-transplantation for CRF in OLT patients associated with induction therapies. CRF was defined as having a creatinine clearance (CC) lower than 60 mL/min. Of the 97 transplants performed during that period, 72 were still functioning after one year. Of these, 33 patients (45.8%) had CRF. In univariate analysis, the predicting factors for CRF were recipient sex (female), initial liver disease (HCV-related cirrhosis), pre-transplant CC ( 130 μmol/L at day 3 and months (M) 1, 3, and 6. In multivariate analysis, the independent predictive factors for CRF included female sex [OR: 11.5 (2.3–58.3); p = 0.003], HCV infection [OR: 5.01 (1.1–22.7); p = 0.03], pre-OLT CC