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Shifting perspectives in liver diseases after kidney transplantation

Iva Kosuta1, Ana Ostojic2, Ana Vujaklija Brajkovic3,4

  • 1Department of Intensive Care Medicine, University Hospital Centre Zagreb, Zagreb 10000, Croatia. ivakosuta@gmail.com.

World Journal of Hepatology
|August 7, 2023
PubMed

Insights

Liver diseases in kidney transplant patients are evolving due to new treatments and emerging viruses like COVID-19. This review offers updated insights for managing these liver complications effectively.

Area of Science:

  • Nephrology
  • Hepatology
  • Transplantation Medicine

Background:

  • Liver diseases are a significant concern for kidney transplant recipients, ranging from mild issues to severe conditions like hepatitis and cirrhosis.
  • Causes include viral infections, drug toxicity, and metabolic disorders, with a notable shift in prevalence over the last decade.
  • Recent advancements in treating hepatitis C, hepatitis B vaccination, and understanding drug-induced liver injury have altered the landscape of liver disease in this population.

Purpose of the Study:

  • To provide healthcare professionals with a comprehensive overview of recent advancements in managing liver complications in kidney transplant recipients.
  • To enhance understanding of the evolving aetiology and management strategies for liver disease in this specific patient group.
  • To support informed decision-making regarding the risks and impact of liver disease post-kidney transplantation.

Main Methods:

  • This review synthesizes current literature and clinical guidelines on liver diseases in kidney transplant recipients.
  • It analyzes changes in the aetiology of liver disease over the past decade.
  • The review incorporates the impact of new therapeutic agents and emerging infectious diseases, such as SARS-CoV-2.

Main Results:

  • The aetiology of liver disease in kidney recipients has significantly changed, influenced by direct-acting antivirals for hepatitis C and hepatitis B vaccination.
  • Improved understanding of drug-induced hepatotoxicity and the challenges posed by the COVID-19 pandemic are critical factors.
  • Current management strategies are adapting to these evolving trends.

Conclusions:

  • Healthcare professionals need updated knowledge to effectively manage liver complications in kidney transplant recipients.
  • Informed decision-making requires awareness of the changing causes and new therapeutic options for liver disease in this population.
  • Continuous adaptation to viral infections and drug-related toxicities is essential for optimizing patient outcomes.
Keywords:
COVID-19Drug-induced liver injuryKidney transplantationNon-alcoholic fatty liver diseaseViral hepatitis

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