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Updated: Aug 12, 2026
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Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
Published on: May 7, 2019
End-stage renal disease in liver transplants
1Department of Surgery, Louisiana State University Health Sciences Center, Shreveport 71106, USA.
Clinical Transplantation
|March 21, 2002
Summary
Cyclosporine (CsA) may not be the sole cause of end-stage renal disease (ESRD) after liver transplants. Other underlying conditions and factors might contribute to kidney failure in these patients.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Medicine
Background:
- Renal dysfunction is a major complication post-orthotopic liver transplantation (OLTx).
- Cyclosporine (CsA) nephrotoxicity is widely suspected as the primary cause of renal impairment and end-stage renal disease (ESRD) in OLTx recipients.
Observation:
- A review of 132 adult end-stage liver disease (ESLD) patients who underwent 146 OLTxs revealed five (3.4%) developed ESRD requiring dialysis.
- Four of these five patients exhibited nephrotic-range proteinuria before progressing to ESRD.
Findings:
- Renal biopsies in four patients indicated diverse pathologies, including focal segmental glomerulosclerosis, diabetic nephropathy, membranous nephropathy, and confirmed cyclosporine toxicity.
- These findings suggest that underlying hepatic and metabolic diseases may contribute to glomerular diseases in OLTx patients.
Implications:
- While CsA/tacrolimus therapy is a recognized risk factor for chronic renal failure post-transplantation, it may not be the exclusive cause of ESRD.
- Increased utilization of renal biopsies in OLTx patients with chronic kidney disease could elucidate the roles of other contributing pathologies beyond immunosuppressive drug toxicity.
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