Management of Renal Failure in the Liver Transplant Patient

  • Michael A. ZimmermanEmail author
  • Jennifer Schiller
  • Motaz Selim
  • Joohyun Kim
  • Johnny C. Hong
Anesthesia and Critical Care in Transplantation (D Axelrod and M Kaufman, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Anesthesia and Critical Care in Transplantation


Purpose of Review

To examine several current issues in the management of patients undergoing orthotopic liver transplantation (OLT) with significant renal injury.

Recent Findings

Review of the recent literature suggests that the actual cause of acute kidney injury (AKI) in cirrhotic patients undergoing OLT may significantly influence outcomes. Strategies such a simultaneous liver-kidney transplant (SLK) and intraoperative renal replacement therapy have been employed to achieve comparable results to either single organ transplant or those without pre-OLT AKI.


With the dramatic rise in acuity at the time of transplant, several strategies have been employed to influence outcomes in OLT recipients with concomitant renal failure. Furthermore, shifts in organ allocation policy have resulted in significant changes in the management of this patient population. At present, the impact of these evolving strategies on long-term graft and patient survival is unknown.


Liver transplant Renal failure High MELD 


Funding Information

This study was supported by the Kevin T. Cottrell Memorial Fund for Organ Transplantation.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Michael A. Zimmerman
    • 1
    Email author
  • Jennifer Schiller
    • 2
  • Motaz Selim
    • 1
  • Joohyun Kim
    • 1
  • Johnny C. Hong
    • 1
  1. 1.Department of Surgery, Division of Transplant SurgeryMedical College of WisconsinMilwaukeeUSA
  2. 2.Laboratory of Histocompatibility and ImmunogeneticsVersiti-WisconsinMilwaukeeUSA

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