Kidney injury and status 1 liver transplantation: Outcomes, kidney function, and listing for kidney transplantation

Daniel J. Cloonan, Madeline R. Cloonan, Scott G. Westphal, Leigh Anne Dageforde, Shaheed Merani

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Effects of kidney injury (KI) at the time of liver transplantation (LT) for acute liver failure (ALF) remain poorly described. We hypothesized that patients with ALF and KI who undergo LT have persistent post-transplant KI, inferior survival, and increased rate of kidney transplantation (KT). Methods: The US Scientific Registry of Transplant Recipients database was queried for patients transplanted with status 1 listing for LT between 2002 and 2021. KI was defined as estimated glomerular filtration rate (eGFR) ≤ 30 mL/min/1.73 m2 or dialysis in the week prior to LT. Outcomes evaluated were post-LT eGFR, listing for subsequent KT, and overall survival (OS) after LT. Results: A total of 2984 patients underwent LT for ALF with 1241 (41.6%) having KI. KI patients had lower eGFR at 6 months post-LT (57.8 vs. 68.7, p <.001) that persisted out to 5 years (59.9 vs. 69.7, p <.001). KI patients were more likely to be listed for KT (4.3% vs. 1.9%, p <.001) and undergo listing sooner after LT (.8 vs. 3.7 years, p <.001). Patients without KI had higher adjusted post-transplant OS compared to those with KI (HR.75, p <.001). Conclusion: KI in the setting of ALF portends a worse prognosis for both kidney recovery and OS.

Original languageEnglish (US)
Article numbere14921
JournalClinical Transplantation
Issue number4
StatePublished - Apr 2023


  • acute liver failure
  • kidney injury after liver transplantation
  • liver transplantation
  • organ allocation

ASJC Scopus subject areas

  • Transplantation


Dive into the research topics of 'Kidney injury and status 1 liver transplantation: Outcomes, kidney function, and listing for kidney transplantation'. Together they form a unique fingerprint.

Cite this