24 May 2022 : Review article
A Systematic Review of the Literature on Chronic Kidney Disease Following Liver Transplantation
Hitomi Miyata1ADE*, Yoshiaki Morita2ADE, Anil Kumar3DEDOI: 10.12659/AOT.935170
Ann Transplant 2022; 27:e935170
Background
Protocol and Registration
Eligibility Criteria and Study Selection Process
Information Sources and Search Strategy
Data Collection Process and Summary Measures
Data Items and Outcomes
Risk of Bias in Individual Studies
Grading of Included Studies
Study Selection
Baseline Characteristics
Immunosuppressive Treatment
Renal Function
CKD Incidence/Prevalence and Stage
Patient and Graft Survival
Graft Rejection
Diabetes
Risk of Bias Across Studies
Discussion
Conclusions
References
Supplementary Table 1 Immunosuppressive treatment dose and trough levels during follow-up for the included studies.
| Author, year [ref] | Study arm | n | Timepoint | Mean±SD TAC dose, mg | Mean±SD TAC trough level, ng/mL | Mean±SD MMF dose, mg/day | Mean±SD everolimus trough level, ng/mL |
|---|---|---|---|---|---|---|---|
| Lin KH et al, 2017 []18 | 18 | Baseline to 12 months | – | Mean ranged from >3– | – | – | |
| 23 | Baseline to 12 months | – | Mean ranged from >3.0– | – | – | ||
| Chen WY et al, 2017 []23 | 14 | 1 month | – | 0.93 ng/mL/mg | – | – | |
| 3 months | – | 0.92 ng/mL/mg | – | – | |||
| 5 months | – | 0.63 ng/mL/mg | – | – | |||
| 7 months | – | 0.78 ng/mL/mg | – | – | |||
| 9 months | – | 0.73 ng/mL/mg | – | – | |||
| 11 months | – | 0.57 ng/mL/mg | – | – | |||
| 13 months | – | 0.66 ng/mL/mg | – | – | |||
| 15 months | – | 1.00 ng/mL/mg | – | – | |||
| 17 months | – | 1.10 ng/mL/mg | – | – | |||
| 28 | 1 month | – | 0.88 ng/mL/mg | – | – | ||
| 3 months | – | 0.88 ng/mL/mg | – | – | |||
| 5 months | – | 1.05 ng/mL/mg | – | – | |||
| 7 months | – | 1.05 ng/mL/mg | – | – | |||
| 9 months | – | 1.28 ng/mL/mg | – | – | |||
| 11 months | – | 1.12 ng/mL/mg | – | – | |||
| 13 months | – | 0.96 ng/mL/mg | – | – | |||
| 15 months | – | 1.58 ng/mL/mg | – | – | |||
| 17 months | – | 1.42 ng/mL/mg | – | – | |||
| Lladó L et al, 2019 []26 | 69 | Transplantation | – | – | 1.0±0.5 g/12 hours | – | |
| 1 day | – | – | 1.0 g/12 hours | – | |||
| 2 days | 6.6 | 7.3 | 1.1 g/12 hours | – | |||
| 7 days | 10.9 | 9.5±6.3 | 1.1 g/12 hours | – | |||
| 10 days | 10.3 | 9.4±5.4 | 1.1 g/12 hours | – | |||
| 1 month | 8.4 | 8.0±3.1 | 1.2 g/12 hours | – | |||
| 3 months | 7.8 | 7.8±3.7 | 1.3 g/12 hours | – | |||
| 6 months | 6.1 | 8.0±4.1 | 1.3 g/12 hours | – | |||
| 12 months | 5.1 | 7.2±3.1 | 1.3±0.4 g/12 hours | – | |||
| Hong S et al, 2017 []27 | 48 | 0 weeks (treatment initiation) | 1.2±0.6 | – | 708.3±249.1 | – | |
| 1 week | 3.1±1.0 | – | 937.5±167.1 | – | |||
| 2 weeks | 4.9±1.8 | – | 988.6±75.4 | – | |||
| 4 weeks | 4.9±1.9 | – | 976.7±152.5 | – | |||
| 6 weeks | 5.0±2.0 | – | 976.2±107.8 | – | |||
| 8 weeks | 5.0±1.8 | – | 1000.0±0.0 | – | |||
| 12 weeks | 4.8±1.9 | – | 1000.0±0.0 | – | |||
| 16 weeks | 4.4±1.8 | – | 1000.0±0.0 | – | |||
| 20 weeks | 4.1±1.6 | – | 1000.0±0.0 | – | |||
| 24 weeks | 4.0±1.7 | – | 1000.0±0.0 | – | |||
| Jochmans I et al, 2017 []28 | 21 | 1 day (post transplantation) | – | Median (IQR)1 (1–2) | – | – | |
| 2 days | – | 3 (1–4) | – | – | |||
| 3 days | – | 5 (2–8) | – | – | |||
| 4 days | – | 6 (5–8) | – | – | |||
| 5 days | – | 6 (5–8) | – | – | |||
| 59 | 1 day (post transplantation) | – | Median (IQR)1 (1–1) | – | – | ||
| 2 days | – | 2 (1–4) | – | – | |||
| 3 days | – | 5 (2–8) | – | – | |||
| 4 days | – | 6 (3–9) | – | – | |||
| 5 days | – | 6 (5–9) | – | – | |||
| Dopazo C et al, 2018 []29 | 20 | 7 days | – | Median (range)3 (1–8) | – | – | |
| Sharma P et al, 2019 []7 | 93 | 1 month | – | Median (IQR)8.2 (7.0–9.6) | – | – | |
| 6 months | – | 6.7 (5.6–8.6) | – | – | |||
| 12 months | – | 6.7 (5.3–7.8) | – | – | |||
| Last follow-up | – | 5.6 (4.2–7.7) | – | – | |||
| Lim Y-T et al, 2020 []19 | 78 | Discharge | Median9 | – | – | – | |
| 3 days to 15 days post transplantation | – | WITHOUT basiliximab induction: median ranged from >2.5–1– | – | – | |||
| 30 days to 180 days post transplantation | – | WITHOUT basiliximab induction: median ranged from >6–6– | – | – | |||
| Saliba F et al, 2017 []22 | 93 | Between transplantation and randomization | – | – | 1312±312 (EC-MPS) | – | |
| Randomization | – | 8.8±3.1 | – | – | |||
| Transplantation to 16 weeks | – | – | – | ||||
| 16 weeks | – | – | – | 7.2±3.5 | |||
| 24 weeks | – | – | 1131±394 (EC-MPS) | 7.7±3.5 | |||
| 95 | Between transplantation and randomization | – | – | 1349±252 (EC-MPS) | – | ||
| Randomization | – | 8.7±4.0 | – | – | |||
| 24 weeks | – | 7.8±2.7 | 1125±400 (EC-MPS) | – | |||
| Yoon K et al, 2018 []21 | 11 | Time of first GFR measurement | – | 5.0±1.85 | – | – | |
| 30 | Time of first GFR measurement | – | 4.7±2.3 | – | – | ||
| 10 | Time of first GFR measurement | – | 5.0±2.2 | – | – | ||
| * ATG first dose mean±SD, 74±10 mg (n=20); second dose: 79±7 mg (n=13); third dose: 78±16 mg (n=4); median (range) dose: 1.96 (0.65–4.16) mg/kg; median (range) total dose: 160 (50–300) mg. ** Steroids were given to most patients (everolimus group 97.8% of patients, tacrolimus group 96.8%) at transplantation. At week 12, 78.0% and 84.9% of patients in the everolimus and tacrolimus groups, respectively, were receiving steroids (median daily dose 0.1 mg/kg in both groups [8.0 and 6.0 mg/day, respectively]); at week 24, 58.4% and 55.7% of patients, respectively, were receiving steroids (median daily dose 0.1 mg/kg [5.0 mg/day] in both groups). AKI – acute kidney injury; ATG – anti-human T-lymphocyte globulin; EC-MPS – enteric-coated mycophenolate sodium; GFR – glomerular filtration rate; IL-2 – interleukin 2; IQR – interquartile range; MMF – mycophenolate mofetil; OLT – orthotopic liver transplantation; QD – once daily; SD – standard deviation; TAC – tacrolimus. | |||||||