Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Davis, Connie L.; Gonwa, Thomas A.; Wilkinson, Alan H.

doi:10.1053/jlts.2002.31516

Cited by 117 publications

(138 citation statements)

References 193 publications

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“…19,20 Many factors, including increased bile acids, endotoxins, circulating immune complexes and various cytokines, nephrotoxic drugs, and hitherto unrecognized factors, predispose patients with cirrhosis to renal dysfunction. [21][22][23] Some of these factors also may play a role in progression of renal disease after liver transplant. 21,24,25 Previous studies have attempted to identify risk factors for posttransplant renal failure.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23] Some of these factors also may play a role in progression of renal disease after liver transplant. 21,24,25 Previous studies have attempted to identify risk factors for posttransplant renal failure. Nair and associates 13 found posttransplant alcohol use and diabetes mellitus were independent predictors of late-onset renal failure, especially in patients with hepatitis C virus.…”

Section: Discussionmentioning

confidence: 99%

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Long-term Outcome of Conversion to Sirolimus Monotherapy After Liver Transplant

Uhlmann

Weber²,

Ludwig³

et al. 2012

Exp Clin Transplant

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Objectives: This study sought to assess the longterm efficacy and safety of conversion from a calcineurin inhibitor-based immunosuppressive regimen to sirolimus monotherapy in liver transplant recipients with renal dysfunction. Materials and Methods: Twenty-five liver transplant recipients with calcineurin inhibitor-based immunosuppression were included in this singlecenter, prospective study. Indications were renal dysfunction, avoidance of tumor recurrence, combination renal dysfunction and avoidance of tumor recurrence, and calcineurin inhibitor-related adverse effects. Results: Mean interval between liver transplant and initiation of sirolimus monotherapy was 51.7 months. The mean follow-up was 75.6 months. The mean ± SD sirolimus whole-blood trough level was 9.0 ± 2.8 ng/mL after 6 months and 6.0 ± 1.8 ng/mL after 18 months. No rejection episode occurred. There was an improvement of the mean creatinine level: 156.1 ± 54.9 µmol/L before conversion versus 129.1 ± 34.7 µmol/L approximately 3 years after conversion (P < .05). The glomerular filtration rate, measured by technetium Tc-99m-diethylenetriamine penta acetic aerosol scintigraphy, improved from 27.4 ± 6.8 mL/min/1.73 m 2 before conversion to 43.3 ± 6.3 mL/min/1.73 m 2 at final follow-up. Proteinuria increased after conversion to sirolimus after 6 months (P < .05) and at last follow-up. The systolic blood pressure decreased from 151.5 ± 20.2 to 132.1 ± 19.4 mm Hg, and the diastolic from 89.7 ± 11.2 to 82.1 ± 9.1 mm Hg at last followup. Serum cholesterol and serum triglyceride levels were nearly unchanged. However, 50% of the patients were treated with lipid-lowering agents. Four patients had sirolimus-induced adverse effects (thrombocytopenia, gingival hyperplasia, oral ulceration). Conclusions: Conversion from calcineurin inhibitors to sirolimus monotherapy after liver transplant results in stabilization of renal function in 75% to 85% of cases and of blood pressure, without increased risk of rejection. The spectrum of adverse effects is low.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term Outcome of Conversion to Sirolimus Monotherapy After Liver Transplant

Uhlmann

Weber²,

Ludwig³

et al. 2012

Exp Clin Transplant

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“…The development of AKI after liver injury greatly increases mortality and morbidity in patients. 2 Injury to remote organs has been attributed to oxidative stress mediators and other remotely released factors, including proinflammatory cytokines, tumor necrosis factor (TNF), and interleukin-1. However, the mechanisms underlying this response are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment with Pentoxifylline andN-Acetylcysteine in Liver Ischemia Reperfusion-Induced Renal Injury

et al. 2012

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“…Hepatic ischemia reperfusion (IR) is a frequent cause of acute liver failure during the perioperative period and occurs frequently after major liver resection or liver transplantation (Davis et al, 2002;Lee et al, 2009). Acute kidney injury (AKI) is common in patients who sustain hepatic IR injury, and the development of AKI in addition to liver injury greatly increases mortality and morbidity during the perioperative period (Davis et al, 2002).…”

mentioning

confidence: 99%

Protection against Acute Kidney Injury via A₁Adenosine Receptor-Mediated Akt Activation Reduces Liver Injury after Liver Ischemia and Reperfusion in Mice

Park

Chen²,

Kim³

et al. 2010

J Pharmacol Exp Ther

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Hepatic ischemia reperfusion (IR) injury causes acute kidney injury (AKI). However, the contribution of AKI to the pathogenesis of liver IR injury is unclear. Furthermore, controversy still exists regarding the role of A 1 adenosine receptors (A 1 ARs) in AKI. In this study, we determined whether exogenous and endogenous A 1 AR activation protects against AKI with subsequent liver protection after hepatic IR in mice. We found that after hepatic IR A 1 knockout (KO) mice and A 1 AR antagonisttreated A 1 wild-type (WT) mice developed worse AKI and liver injury compared with vehicle-treated A 1 WT mice. Moreover, a selective A 1 AR agonist protected against hepatic IR-induced AKI and liver injury in A 1 WT mice.

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Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Cited by 117 publications

References 193 publications

Long-term Outcome of Conversion to Sirolimus Monotherapy After Liver Transplant

Long-term Outcome of Conversion to Sirolimus Monotherapy After Liver Transplant

Pretreatment with Pentoxifylline andN-Acetylcysteine in Liver Ischemia Reperfusion-Induced Renal Injury

Protection against Acute Kidney Injury via A₁Adenosine Receptor-Mediated Akt Activation Reduces Liver Injury after Liver Ischemia and Reperfusion in Mice

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Pathophysiology of renal disease associated with liver disorders: Implications for liver transplantation. Part I

Cited by 117 publications

References 193 publications

Long-term Outcome of Conversion to Sirolimus Monotherapy After Liver Transplant

Long-term Outcome of Conversion to Sirolimus Monotherapy After Liver Transplant

Pretreatment with Pentoxifylline andN-Acetylcysteine in Liver Ischemia Reperfusion-Induced Renal Injury

Protection against Acute Kidney Injury via A1Adenosine Receptor-Mediated Akt Activation Reduces Liver Injury after Liver Ischemia and Reperfusion in Mice

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Resources

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Protection against Acute Kidney Injury via A₁Adenosine Receptor-Mediated Akt Activation Reduces Liver Injury after Liver Ischemia and Reperfusion in Mice