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
Table 3 Study characteristics and treatment regimens for the 14 publications included in the systematic literature review.
Author, year [ref] | Study design | Level of evidence* | Country | Total study N | Study arm(s) with treatment regimen (if available) | Study arm n | Duration of follow-up, months |
---|---|---|---|---|---|---|---|
Lin KH et al, 2017 []18 | Single center, cross-sectional retrospective | 3 | Taiwan | 41 | TAC+MMF+steroid+telbivudine 600 mg QD | 18 | 12 |
TAC+MMF+steroid+entecavir 1 mg QD | 23 | 12 | |||||
Chen WY et al, 2017 []23 | Single center, retrospective, matched case-control | 4 | Taiwan | 42 | TAC QD (Advagraf) – betel nut chewers | 14 | 18 |
TAC QD (Advagraf) – non-betel nut chewers | 28 | 18 | |||||
Gojowy D et al, 2020 []24 | Single center, retrospective | 3 | Poland | 130 | 24 months post liver transplant: TAC-based, CsA-based, or everolimus-based+low-dose TAC, with or without prednisone and MMF | 130 | 24 |
Levitsky J et al, 2020 []25 | Multicenter, retrospective | 4 | USA | 60 (CTOT14 cohort only) | Diminished eGFR (>10% decline in eGFR from baseline [3 months post transplantation] to year 1, with ≥50% intervening eGFR values lower than baseline eGFR) (86% received CNI therapy at baseline) | 28 | 12 |
Preserved eGFR (≤10% decline in eGFR, with ≥50% of the intervening eGFR values within 10% of baseline eGFR) (97% received CNI therapy at baseline) | 32 | 12 | |||||
Lladó L et al, 2019 []26 | Single center, observational, prospective | 4 | Spain | 69 | Delayed initiation TAC QD (Advagraf)+corticosteroid+MMF | 69 | 12 |
Hong S et al, 2017 []27 | Single center, phase 4, open-label, noncomparative, explorative | 4 | South Korea | 48 | TAC+MMF±steroids | 48 | 6 |
Jochmans I et al, 2017 []28 | Single center, prospective cohort | 3 | Belgium | 80 | TAC+MMF+steroid – post OLT AKI | 21 | 12 |
TAC+MMF+steroid – post OLT normal renal function | 59 | 12 | |||||
Dopazo C et al, 2018 []29 | Single center, prospective, cohort | 4 | Spain | 40 | ATG induction+TAC+steroids – renal dysfunction at liver transplant** | 20 | 12 |
Pascher A et al, 2015 []30 | Multicenter, phase 2, randomized, partially blinded | 2 | 12 countries | 200 | Sotrastaurin 200 mg BID+standard TAC (5–10 ng/mL)+steroid | 49 | 6 |
Sotrastaurin 200 mg BID+reduced TAC (2–5 ng/mL)+steroid | 51 | 6 | |||||
Sotrastaurin 300 mg BID+reduced TAC (2–5 ng/mL)+steroid | 49 | 6 | |||||
Standard TAC (5–10 ng/mL)+MMF 1000 mg BID+steroid | 51 | 6 | |||||
Sharma P et al, 2019 []7 | Single center, retrospective, observational, cohort | 3 | USA | 214 | TAC+MMF+steroids** | 93 | Last follow-up median 4 years (2.9–5.1) |
Lim Y-T et al, 2020 []19 | Single center, prospective, open-label, sequential cohort analysis | 3 | UK | 160 | TAC QD (+basiliximab in patients with eGFR <50 mL/min at liver transplant; +MMF as renal-sparing strategy)** | 78 | 6 |
Saliba F et al, 2017 []22 | Multicenter, prospective, randomized, open-label | 2 | France | 188 | TAC+EC-MPS±steroids, then everolimus | 93 | 6 |
TAC+EC-MPS±steroids | 95 | 6 | |||||
Chauhan KC et al, 2018 []20 | Single center, retrospective, case-control | 4 | USA | 290 | Overall | 290 | 24 |
No pre-liver transplant CKD stage 3 | 223 | 24 | |||||
Pre-liver transplant CKD stage 3 (eGFR 30–60 >3 months) | 67 | 24 | |||||
No pre-liver transplant AKI | 149 | 24 | |||||
Pre-liver transplant AKI (≥25% increase in serum creatinine from baseline lasting <3 months) | 141 | 24 | |||||
Yoon K et al, 2018 []21 | Single center, observational | 3 | South Korea | 51 | Normal GFR (>90 mL/min/1.73 m at assessment 43.9±25.4 months after surgery) | 11 | 12 |
Mild reduction in GFR (60–89 mL/min/1.73 m at assessment 46.6±27.0 months after surgery) | 30 | 12 | |||||
Moderate reduction in GFR (30–59 mL/min/1.73 m at assessment 37.7±24.9 months after surgery) | 10 | 12 | |||||
* Assessed using the Oxford Centre for Evidence-based Medicine – Levels of Evidence. ** Only one study arm included, as the comparator arm did not meet eligibility criteria. AKI – acute kidney injury; ATG – anti-human T-lymphocyte globulin; BID – twice daily; CKD – chronic kidney disease; CNI – calcineurin inhibitor; CsA – ciclosporin A; EC-MPS – enteric-coated mycophenolate sodium; eGFR – estimated glomerular filtration rate; GFR – glomerular filtration rate; ICU – intensive care unit; IV – intravenous; MMF – mycophenolate mofetil; OLT – orthotopic liver transplantation; QD – once daily; TAC – tacrolimus. |