O238 Introduction: Renal dysfunction is common after liver transplantation (LT) and is a major source of morbidity and mortality. Renal function before LT, immunosuppressive drugs, hepatitis C (HCV) and comorbidities such as diabetes and hypertension are identified risk factors of impaired renal function. The aim of our study was to assess the prevalence of renal dysfunction 5 years after LT and to identify risk factors for the development of this complication. Patients and methods: 136 adult patients underwent LT at our institution from December 1987 to December 98. 104 of them were alive 5 years after LT, 7 died between 5 and 9 years after LT. 6 patients were lost to follow up. We reviewed the medical records of theses 104 patients and analysed data on the following potential risk factors of renal dysfunction: age, aetiology of liver disease, hepato-renal syndrome, immediate post-LT dialysis, nephrotoxic drug administration, immunosuppressive regimens, and comorbidities such as diabetes and hypertension. Pre-LT, 1 and 5 years post LT renal function was calculated according to Cockroft and the Modification of Diet in Renal Disease formula (MDRD). Since 1997, patients had annually post-LT glomerular filtration rate (GFR) determination by radiolabeled tracers clearance (RTC). We determinate the correlation between RTC, MDRD and Cockroft GFR. Risk factors for GFR < 50 ml/min were analysed using a multivariate logistic regression model with the statistical package SPSS. Results: Mean pre-transplantation Cockroft and MDRD GFR was 79 and 87 ml/min respectively; 11 (11%) and 8 (8%) patients had a GFR ≤ 50 ml/min with an hepato-renal syndrome and 3 patients needed immediate post LT dialysis. 5 years after LT; mean GFR was 70 and 62 and 63 ml/min with RTC, Cockroft and MDRD respectively. 32 (34%), 25 (27%) and 11 (15%) had a GFR ≤50 ml/min with Cockroft, MDRD and RTC respectively. There was a better correlation between GFR at five years measured with both the RTC and the MDRD formula (r=0.727) than with both the RTC and the Cockroft formula (r=0.613). Using a multivariate logistic regression model, independant risk factors associated with impaired renal function at 5 years were the presence of an arterial hypertension at 5 years (p=0.04), of through levels of cyclosporine (CyA) ≥ 150 [wpgrcent]58[/wpgrcent]g/l and of tacrolimus (FK) ≥ 10 [wpgrcent]58[/wpgrcent]g/l one year after LT (p=0.05) and through levels of CyA ≥ 100 [wpgrcent]58[/wpgrcent]g/l and of FK ≥ 8[wpgrcent]58[/wpgrcent]/l 5 years after LT. Conclusions: 5 years after LT, impairment of renal function occurred in 15 to 27% of the patients according to the method used to assess GFR. Late-onset renal failure can be predicted by arterial hypertension and high doses of calcineurin inhibitors. To decrease this complication, a strict control of blood pressure and lower calcineurin inhibitors doses (CyA and FK through levels ≤ 150 [wpgrcent]58[/wpgrcent]g/l and 10 [wpgrcent]58[/wpgrcent]g/l one year after LT and ≤ 100 [wpgrcent]58[/wpgrcent]g/l and 8[wpgrcent]58[/wpgrcent]/l 5 years after LT) are needed.