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Kidney Biopsies May Help Predict Renal Function After Liver Transplantation
Raimund H Pichler1, Janna Huskey, Jolanta Kowalewska
11 Departments of Medicine, Pathology and Surgery, University of Washington, Seattle, WA.
Transplantation
|August 2, 2016
Summary
Renal biopsies are safe and useful for liver transplant candidates with kidney problems. They help determine transplant type and predict kidney function, avoiding unnecessary kidney transplants in 70% of cases.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Medicine
Background:
- Renal biopsy is proposed for end-stage liver disease patients to assess renal failure causes and reversibility.
- Its utility in kidney allocation for liver transplant candidates requires further validation.
Purpose of the Study:
- Evaluate the utility of renal biopsies in liver transplant candidates with renal impairment.
- Analyze pathological diagnoses, patient outcomes, and biopsy result predictability for renal recovery.
Main Methods:
- Retrospective analysis of 59 liver transplant candidates with renal impairment.
- Evaluation of transjugular and percutaneous renal biopsy complication rates.
- Correlation of histological findings with post-transplant kidney function and outcomes.
Main Results:
- Low complication rates for renal biopsies (2.9% transjugular, 4.2% percutaneous).
- Common diagnoses: membranoproliferative glomerulonephritis, IgA nephropathy, acute tubular injury.
- Biopsy criteria avoided kidney allocation for 70% of patients; predicted post-transplant kidney function.
Conclusions:
- Renal biopsy is safe and elucidates renal failure etiology in liver transplant candidates.
- Biopsies predict post-liver transplant alone (LAT) kidney function and aid kidney allocation.
- Biopsy findings help guide decisions between simultaneous liver-kidney transplantation (SLK) and LAT.
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