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24 May 2022: Review Paper

A Systematic Review of the Literature on Chronic Kidney Disease Following Liver Transplantation

Hitomi Miyata 1ADE* , Yoshiaki Morita 2ADE , Anil Kumar 3DE

DOI: 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 designLevel of evidence*CountryTotal study NStudy arm(s) with treatment regimen (if available)Study arm nDuration of follow-up, months
Lin KH et al, 2017 []18 Single center, cross-sectional retrospective3Taiwan41TAC+MMF+steroid+telbivudine 600 mg QD1812
TAC+MMF+steroid+entecavir 1 mg QD2312
Chen WY et al, 2017 []23 Single center, retrospective, matched case-control4Taiwan42TAC QD (Advagraf) – betel nut chewers1418
TAC QD (Advagraf) – non-betel nut chewers2818
Gojowy D et al, 2020 []24 Single center, retrospective3Poland13024 months post liver transplant: TAC-based, CsA-based, or everolimus-based+low-dose TAC, with or without prednisone and MMF13024
Levitsky J et al, 2020 []25 Multicenter, retrospective4USA60 (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)2812
Preserved eGFR (≤10% decline in eGFR, with ≥50% of the intervening eGFR values within 10% of baseline eGFR) (97% received CNI therapy at baseline)3212
Lladó L et al, 2019 []26 Single center, observational, prospective4Spain69Delayed initiation TAC QD (Advagraf)+corticosteroid+MMF6912
Hong S et al, 2017 []27 Single center, phase 4, open-label, noncomparative, explorative4South Korea48TAC+MMF±steroids486
Jochmans I et al, 2017 []28 Single center, prospective cohort3Belgium80TAC+MMF+steroid – post OLT AKI2112
TAC+MMF+steroid – post OLT normal renal function5912
Dopazo C et al, 2018 []29 Single center, prospective, cohort4Spain40ATG induction+TAC+steroids – renal dysfunction at liver transplant** 2012
Pascher A et al, 2015 []30 Multicenter, phase 2, randomized, partially blinded212 countries200Sotrastaurin 200 mg BID+standard TAC (5–10 ng/mL)+steroid496
Sotrastaurin 200 mg BID+reduced TAC (2–5 ng/mL)+steroid516
Sotrastaurin 300 mg BID+reduced TAC (2–5 ng/mL)+steroid496
Standard TAC (5–10 ng/mL)+MMF 1000 mg BID+steroid516
Sharma P et al, 2019 []7 Single center, retrospective, observational, cohort3USA214TAC+MMF+steroids** 93Last follow-up median 4 years (2.9–5.1)
Lim Y-T et al, 2020 []19 Single center, prospective, open-label, sequential cohort analysis3UK160TAC QD (+basiliximab in patients with eGFR** 786
Saliba F et al, 2017 []22 Multicenter, prospective, randomized, open-label2France188TAC+EC-MPS±steroids, then everolimus936
Chauhan KC et al, 2018 []20 Single center, retrospective, case-control4USA290Overall29024
No pre-liver transplant CKD stage 322324
Pre-liver transplant CKD stage 3 (eGFR 30–60 >3 months)6724
No pre-liver transplant AKI14924
Pre-liver transplant AKI (≥25% increase in serum creatinine from baseline lasting14124
Yoon K et al, 2018 []21 Single center, observational3South Korea51Normal GFR (>90 mL/min/1.73 m at assessment 43.9±25.4 months after surgery)1112
Mild reduction in GFR (60–89 mL/min/1.73 m at assessment 46.6±27.0 months after surgery)3012
Moderate reduction in GFR (30–59 mL/min/1.73 m at assessment 37.7±24.9 months after surgery)1012
* 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.

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358