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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
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Chronic Kidney Disease After Liver Transplantation.
Ramon O Minjares1, Paul Martin2, Andres F Carrion2
1Department of Internal Medicine, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Suite 600-D, Miami, FL 33136, USA.
Clinics in Liver Disease
|April 29, 2022
Summary
Liver transplant recipients face increased risk of kidney problems due to factors like medication toxicity and metabolic issues. Strategies like delayed calcineurin inhibitor use may help preserve kidney function in these patients.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Medicine
Background:
- Long-term survival post-liver transplantation (LT) results in an aging recipient population susceptible to kidney dysfunction.
- Key risk factors for renal impairment include calcineurin inhibitor (CNI) nephrotoxicity, pre-existing kidney issues, and perioperative acute kidney injury.
- Metabolic complications like hypertension, diabetes mellitus, and metabolic-associated fatty liver disease exacerbate renal disease progression in LT recipients.
Purpose of the Study:
- To review the multifactorial causes of renal dysfunction in liver transplant recipients.
- To discuss established criteria for simultaneous liver and kidney transplantation.
- To explore strategies for mitigating renal dysfunction progression in the LT population.
Main Methods:
- Literature review and synthesis of existing data on renal dysfunction after liver transplantation.
- Analysis of risk factors, including immunosuppressive agents and metabolic comorbidities.
- Examination of current guidelines for combined organ transplantation and nephroprotective strategies.
Main Results:
- Most liver transplant recipients develop some degree of renal dysfunction over time.
- Specific criteria exist for identifying candidates suitable for simultaneous liver and kidney transplantation.
- Delayed CNI introduction and renal-sparing immunosuppressive therapies show potential in reducing renal disease progression.
Conclusions:
- Renal dysfunction is a common and significant long-term complication following liver transplantation.
- Careful patient selection for combined transplantation and judicious use of immunosuppressants are crucial.
- Implementing nephroprotective measures, such as modified CNI protocols, can help preserve kidney function in liver transplant recipients.
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