Renal Function Deterioration Is Higher Within The First Year After Liver Transplantation: Results of The Italian Cross-Sectional, Multicenter Study (SURF).

Abstract

Background: Previous evidence suggests that renal function (RF) deterioration occurs early after liver transplantation (LT) when exposure to calcineurin inhibitors (CNI) is higher. Materials and methods: SURF was a cross-sectional, multicenter study to investigate the prevalence of renal dysfunction (eGFR <60mL/min/1.73m2) and the retrospectively recorded evolution of RF after transplantation in maintenance (5 months (M) to 5.5 years) recipients of a primary liver graft. Results: From March 2012 to June 2013 a sample of 1,002 evaluable patients were enrolled at a mean of 28.6±16.5 M from LT. From LT to inclusion, mean eGFR decreased from 95.7±36.9 mL/min/1.73m2 to 76.9±25.7 mL/min/1.73m2. Mean yearly eGFR deterioration was -12.3±32.2 mL/min/1.73m2 which resulted from a mean of -26.2±59 mL/min/1.73m2 within 1 year after LT (n=964); -13.3±24.4 mL/min/1.73m2 between 1 and 2 years (n=675); -8.5±15.5 mL/min/1.73m2 between 2 and 3 years (n=437); -5.7±9.6 mL/min/1.73m2 between 3 and 4 years (n=244 pts); and -3.9±8.2 mL/min/1.73m2 between 4 and 5.5 years (n=98). 91% patients were on CNI-based immunosuppression at inclusion (726 TAC; 187 CsA) (monotherapy 54%; combination 46%). Mean duration of CNI monotherapy was 23.16±17.62 M, and was 26.79±18.19 M for CNI in combination. Conclusions: LT recipients experience greater RF deterioration within the first post-transplant year, and the large majority are on CNI-based immunosuppression. These data call for preventative strategies early on after transplantation to slow down RF impairment. DISCLOSURES:De Simone, P.: Speaker's Bureau, Novartis, Astellas. Cillo, U.: Speaker's Bureau, Novartis. Burra, P.: Speaker's Bureau, Novartis. Donati, D.: Speaker's Bureau, Novartis. Brusa, R.: Employee, Novartis. Fagiuoli, S.: Speaker's Bureau, Novartis.