Chronic Kidney Disease After Orthotopic Liver Transplantation: Impact of Hepatitis C Infection

Background. Hepatitis C virus (HCV) infection has been shown to be a potential risk factor for the development of chronic kidney disease in liver transplant recipients. Methods. We performed a retrospective cohort study of 307 patients with and without HCV cirrhosis and preserved pretransplant renal function (serum creatinine < 1.5 mg/dL pretransplantation) to assess the impact of HCV on the incidence of posttransplant chronic kidney disease. Kaplan-Meier analysis was performed for time to development of estimated glomerular filtration rate (eGFR) less than 30 mL/min, need for dialysis, and mortality. Results. One hundred eighty-one patients were transplanted for HCV cirrhosis and 126 recipients had other causes of liver disease. Mean model for end-stage liver disease scores were 21.64 in the HCV group and 21.30 in the non-HCV group (P = 0.58); 51% of patients in the HCV cohort had hepatocellular carcinoma compared with 27% in the non-HCV cohort (P < 0.001). Mean pretransplant serum creatinine level was 0.89 mg/dL in both groups. At 3 years posttransplant, eGFR did not differ between the HCV and non-HCV cohorts (64.96 mL/min vs. 66.09 mL/min; P = 0.71). A total of 14.4% of the patients with HCV achieved an eGFR less than 30 mL/min compared with 10.3% of the patients without HCV(P = 0.13). There was no difference between the cohorts with respect to requirement for dialysis (P = 0.73) or deaths (P = 0.08), including those that were liver related (P = 0.15). Conclusions. Patients with HCV cirrhosis and normal preliver transplant renal function do not have worse posttransplant renal outcomes compared with those with other causes of liver disease.