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

Hitomi Miyata; Yoshiaki Morita; Anil Kumar

doi:10.12659/AOT.935170

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

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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
Lin KH et al, 2017 []¹⁸	Single center, cross-sectional retrospective	3	Taiwan	41	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
Chen WY et al, 2017 []²³	Single center, retrospective, matched case-control	4	Taiwan	42	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
Levitsky J et al, 2020 []²⁵	Multicenter, retrospective	4	USA	60 (CTOT14 cohort only)	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
Jochmans I et al, 2017 []²⁸	Single center, prospective cohort	3	Belgium	80	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^**	78	6
Saliba F et al, 2017 []²²	Multicenter, prospective, randomized, open-label	2	France	188	TAC+EC-MPS±steroids, then everolimus	93	6
Saliba F et al, 2017 []²²	Multicenter, prospective, randomized, open-label	2	France	188	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	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.

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

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