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. 2019 Jun;7(11):243.
doi: 10.21037/atm.2019.05.22.

Pretransplant renal function evaluated by serum cystatin C was associated with mortality after liver transplantation: a single-center experience

Yuan Ding  1   2   3   4   5 , Tianchun Wu  1   2   3   4   5 , Wenyan Zhang  6 , Sitong Zhang  1   2   3   4   5 , Weilin Wang  1   2   3   4   5
Affiliations

Pretransplant renal function evaluated by serum cystatin C was associated with mortality after liver transplantation: a single-center experience

Yuan Ding et al. Ann Transl Med. 2019 Jun.

Abstract

Background: In the model for end-stage liver disease (MELD) score, renal function was well thought to be associated with the prognosis of liver recipients. Serum cystatin C (CystC)-based equations were considered more accurate for calculating estimated glomerular filtration rate (eGFR) than creatinine (Pcr) based equations. Thus, we aimed to assess the association between eGFR estimated by chronic kidney disease epidemiology collaboration (CKD-EPI)-CystC equation and post-transplantation mortality.

Methods: From January 2015 to January 2018, prior to liver transplantation (LT) and other clinical parameters, CystC was collected in all 307 consecutive patients who underwent LT at our center. Patients were divided into four groups according to the Kidney Disease Outcomes Quality Initiative (KDOQI) classification.

Results: Based on CKD-EPI-CystC and the KDOQI classification, 117 patients (38.1%) were stage I, 76 (24.8%) were stage II, 85 (27.7%) were stage III, and 29 (9.4%) were stage IV-V. After univariate and multivariate analysis, MELD score [hazard ratio (HR) =1.035; 95% confidence interval (CI), 1.006-1.066; P=0.018], associated HCC (HR =2.314; 95% CI, 1.253-4.273; P=0.007), and KDOQI stage III (HR =1.850; 95% CI, 1.001-3.419; P=0.049), and stage IV-V (HR =3.915; 95% CI, 1.843-8.316; P<0.001) according to CKD-EPI-CystC equation were confirmed to be independent prognostic factors for post-LT survival.

Conclusions: The pretransplant renal function evaluated by serum CystC was associated with mortality after LT and could be used for predicting post-transplant survival.

Keywords: Creatinine; estimated glomerular filtration rate; liver transplantation (LT); prognosis; serum cystatin C.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Survival curve of patients underwent liver transplantation according to the KDOQI stage using CKD-EPI-Cys C equation. KDOQI, Kidney Disease Outcomes Quality Initiative; MDRD, modification of diet in renal disease; CKD-EPI, chronic kidney disease epidemiology collaboration; Cys C, serum cystatin C.
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