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Kidney Transplantation in Cirrhotic Patients

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Surgical Procedures on the Cirrhotic Patient

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Abstract

Cirrhotic patients with concurrent end-stage renal disease pose a unique challenge in their management. In many cases, a combined liver and kidney transplantation is performed but there is a significant amount of cases where cirrhosis is well compensated and the patient does not have a straightforward indication for liver transplantation. Kidney transplantation alone could take these patients off dialysis; however, there is the danger of liver decompensation and subsequent mortality, as in any other major surgery performed in cirrhotics. Many centers deny kidney transplantation in cirrhotics, but there are data to support that if planed carefully with appropriate selection of donors and recipients, kidney transplantation alone in certain cirrhotic patients is indicated and appropriate.

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References

  1. Chan EY, Bhattacharya R, Eswaran S, et al. Outcomes after combined liver-kidney transplant vs. kidney transplant followed by liver transplant. Clin Transpl. 2015;29(1):60–6. doi:10.1111/ctr.12484.

    Article  Google Scholar 

  2. Parsikia A, Campos S, Khanmoradi K, et al. Equal 3-year outcomes for kidney transplantation alone in HCV-positive patients with cirrhosis. Int Surg. 2015;100(1):142–54. doi:10.9738/INTSURG-D-13-00231.1.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Morales JM, Fabrizi F. Hepatitis C and its impact on renal transplantation. Nat Rev Nephrol. 2015;11(3):172–82. doi:10.1038/nrneph.2015.5.

    Article  CAS  PubMed  Google Scholar 

  4. Chan TM, Lok AS, Cheng IK, Chan RT. Prevalence of hepatitis C virus infection in hemodialysis patients: a longitudinal study comparing the results of RNA and antibody assays. Hepatology. 1993;17(1):5–8. 0270-9139(93)90183-N [pii].

    Article  CAS  PubMed  Google Scholar 

  5. Finelli L, Miller JT, Tokars JI, Alter MJ, Arduino MJ. National surveillance of dialysis-associated diseases in the United States, 2002. Semin Dial. 2005;18(1):52–61. SDI18108 [pii].

    Article  PubMed  Google Scholar 

  6. Fissell RB, Bragg-Gresham JL, Woods JD, et al. Patterns of hepatitis C prevalence and seroconversion in hemodialysis units from three continents: The DOPPS. Kidney Int. 2004;65(6):2335–42. doi:10.1111/j.1523-1755.2004.00649.x.

    Article  PubMed  Google Scholar 

  7. Jadoul M, Poignet JL, Geddes C, et al. The changing epidemiology of hepatitis C virus (HCV) infection in haemodialysis: European multicentre study. Nephrol Dial Transplant. 2004;19(4):904–9. doi:10.1093/ndt/gfh012.

    Article  PubMed  Google Scholar 

  8. Pereira BJ, Levey AS. Hepatitis C virus infection in dialysis and renal transplantation. Kidney Int. 1997;51(4):981–99.

    Article  CAS  PubMed  Google Scholar 

  9. Covic A, Iancu L, Apetrei C, et al. Hepatitis virus infection in haemodialysis patients from moldavia. Nephrol Dial Transplant. 1999;14(1):40–5.

    Article  CAS  PubMed  Google Scholar 

  10. Hmaied F, Ben Mamou M, Saune-Sandres K, et al. Hepatitis C virus infection among dialysis patients in Tunisia: incidence and molecular evidence for nosocomial transmission. J Med Virol. 2006;78(2):185–91. doi:10.1002/jmv.20526.

    Article  CAS  PubMed  Google Scholar 

  11. Saxena AK, Panhotra BR. The impact of nurse understaffing on the transmission of hepatitis C virus in a hospital-based hemodialysis unit. Med Princ Pract. 2004;13(3):129–35. doi:10.1159/000076951.

    Article  PubMed  Google Scholar 

  12. Morales JM, Campistol JM, Dominguez-Gil B. Hepatitis C virus infection and kidney transplantation. Semin Nephrol. 2002;22(4):365–74. S0270929502500474 [pii].

    PubMed  Google Scholar 

  13. Musso G, Gambino R, Tabibian JH, et al. Association of non-alcoholic fatty liver disease with chronic kidney disease: a systematic review and meta-analysis. PLoS Med. 2014;11(7):e1001680. doi:10.1371/journal.pmed.1001680.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Musso G, Gambino R, Cassader M, Pagano G. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med. 2011;43(8):617–49. doi:10.3109/07853890.2010.518623.

    Article  PubMed  Google Scholar 

  15. Fabrizi F, Poordad FF, Martin P. Hepatitis C infection and the patient with end-stage renal disease. Hepatology. 2002;36(1):3–10. S0270913902000009 [pii].

    Article  PubMed  Google Scholar 

  16. Patel V, Marsano L, Eng M. Decompensated cirrhosis after renal transplantation: a case report. Case Rep Transplant. 2011;2011:862567. doi:10.1155/2011/862567.

    PubMed  PubMed Central  Google Scholar 

  17. Berthoux F. Hepatitis C virus infection and disease in renal transplantation. Nephron. 1995;71(4):386–94.

    Article  CAS  PubMed  Google Scholar 

  18. Glicklich D, Thung SN, Kapoian T, Tellis V, Reinus JF. Comparison of clinical features and liver histology in hepatitis C-positive dialysis patients and renal transplant recipients. Am J Gastroenterol. 1999;94(1):159–63. S0002927098006698 [pii].

    Article  CAS  PubMed  Google Scholar 

  19. Perez RM, Ferreira AS, Medina-Pestana JO, et al. Is hepatitis C more aggressive in renal transplant patients than in patients with end-stage renal disease? J Clin Gastroenterol. 2006;40(5):444–8. 00004836-200605000-00016 [pii].

    Article  PubMed  Google Scholar 

  20. Hanafusa T, Ichikawa Y, Kishikawa H, et al. Retrospective study on the impact of hepatitis C virus infection on kidney transplant patients over 20 years. Transplantation. 1998;66(4):471–6.

    Article  CAS  PubMed  Google Scholar 

  21. Izopet J, Rostaing L, Sandres K, et al. Longitudinal analysis of hepatitis C virus replication and liver fibrosis progression in renal transplant recipients. J Infect Dis. 2000;181(3):852–8. JID991149 [pii].

    Article  CAS  PubMed  Google Scholar 

  22. Rao KV, Anderson WR, Kasiske BL, Dahl DC. Value of liver biopsy in the evaluation and management of chronic liver disease in renal transplant recipients. Am J Med. 1993;94(3):241–50. 0002-9343(93)90055-T [pii].

    Article  CAS  PubMed  Google Scholar 

  23. de Oliveira Uehara SN, Emori CT, da Silva Fucuta Pereira P, et al. Histological evolution of hepatitis C virus infection after renal transplantation. Clin Transpl. 2012;26(6):842–8. doi:10.1111/j.1399-0012.2012.01635.x.

    Article  Google Scholar 

  24. Maluf DG, Fisher RA, King AL, et al. Hepatitis C virus infection and kidney transplantation: predictors of patient and graft survival. Transplantation. 2007;83(7):853–7. doi:10.1097/01.tp.0000259725.96694.0a.

    Article  PubMed  Google Scholar 

  25. Fabrizi F, Martin P, Dixit V, Bunnapradist S, Dulai G. Hepatitis C virus antibody status and survival after renal transplantation: meta-analysis of observational studies. Am J Transplant. 2005;5(6):1452–61. AJT864 [pii].

    Article  CAS  PubMed  Google Scholar 

  26. Rostami Z, Nourbala MH, Alavian SM, Bieraghdar F, Jahani Y, Einollahi B. The impact of hepatitis C virus infection on kidney transplantation outcomes: a systematic review of 18 observational studies: the impact of HCV on renal transplantation. Hepat Mon. 2011;11(4):247–54.

    PubMed  PubMed Central  Google Scholar 

  27. Cruzado JM, Bestard O, Grinyo JM. Impact of extrahepatic complications (diabetes and glomerulonephritis) associated with hepatitis C virus infection after renal transplantation. Contrib Nephrol. 2012;176:108–16. doi:10.1159/000332389.

    Article  PubMed  Google Scholar 

  28. Corell A, Morales JM, Mandrono A, et al. Immunosuppression induced by hepatitis C virus infection reduces acute renal-transplant rejection. Lancet. 1995;346(8988):1497–8. S0140-6736(95)92520-1 [pii].

    Article  CAS  PubMed  Google Scholar 

  29. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30. doi:10.1056/NEJM199912023412303.

    Article  CAS  PubMed  Google Scholar 

  30. Tang IY, Walzer N, Aggarwal N, Tzvetanov I, Cotler S, Benedetti E. Management of the kidney transplant patient with chronic hepatitis C infection. Int J Nephrol. 2011;2011:245823. doi:10.4061/2011/245823.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Fabrizi F, Martin P, Dixit V, Bunnapradist S, Kanwal F, Dulai G. Post-transplant diabetes mellitus and HCV seropositive status after renal transplantation: Meta-analysis of clinical studies. Am J Transplant. 2005;5(10):2433–40. AJT1040 [pii].

    Article  PubMed  Google Scholar 

  32. Campbell MS, Constantinescu S, Furth EE, Reddy KR, Bloom RD. Effects of hepatitis C-induced liver fibrosis on survival in kidney transplant candidates. Dig Dis Sci. 2007;52(10):2501–7. doi:10.1007/s10620-006-9716-x.

    Article  PubMed  Google Scholar 

  33. Mathurin P, Mouquet C, Poynard T, et al. Impact of hepatitis B and C virus on kidney transplantation outcome. Hepatology. 1999;29(1):257–63. S0270913999000348 [pii].

    Article  CAS  PubMed  Google Scholar 

  34. Morales JM, Bloom R, Roth D. Kidney transplantation in the patient with hepatitis C virus infection. Contrib Nephrol. 2012;176:77–86. doi:10.1159/000332385.

    Article  PubMed  Google Scholar 

  35. Morales JM, Aguado JM. Hepatitis C and renal transplantation. Curr Opin Organ Transplant. 2012;17(6):609–15. doi:10.1097/MOT.0b013e32835a2bac.

    Article  CAS  PubMed  Google Scholar 

  36. Bloom RD, Sayer G, Fa K, Constantinescu S, Abt P, Reddy KR. Outcome of hepatitis C virus-infected kidney transplant candidates who remain on the waiting list. Am J Transplant. 2005;5(1):139–44. AJT652 [pii].

    Article  PubMed  Google Scholar 

  37. Pereira BJ, Natov SN, Bouthot BA, et al. Effects of hepatitis C infection and renal transplantation on survival in end-stage renal disease. The New England Organ Bank Hepatitis C Study Group. Kidney Int. 1998;53(5):1374–81. doi:10.1046/j.1523-1755.1998.00883.x.

    Article  CAS  PubMed  Google Scholar 

  38. Espinosa M, Martin-Malo A, Alvarez de Lara MA, Aljama P. Risk of death and liver cirrhosis in anti-HCV-positive long-term haemodialysis patients. Nephrol Dial Transplant. 2001;16(8):1669–74.

    Article  CAS  PubMed  Google Scholar 

  39. Roth D, Gaynor JJ, Reddy KR, et al. Effect of kidney transplantation on outcomes among patients with hepatitis C. J Am Soc Nephrol. 2011;22(6):1152–60. doi:10.1681/ASN.2010060668.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Paramesh AS, Davis JY, Mallikarjun C, et al. Kidney transplantation alone in ESRD patients with hepatitis C cirrhosis. Transplantation. 2012;94(3):250–4. doi:10.1097/TP.0b013e318255f890.

    Article  CAS  PubMed  Google Scholar 

  41. Garcia-Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis. Hepatology. 2008;48(6):2064–77. doi:10.1002/hep.22605.

    Article  CAS  PubMed  Google Scholar 

  42. Angeli P, Sanyal A, Moller S, et al. Current limits and future challenges in the management of renal dysfunction in patients with cirrhosis: report from the International Club of Ascites. Liver Int. 2013;33(1):16–23. doi:10.1111/j.1478-3231.2012.02807.x.

    Article  CAS  PubMed  Google Scholar 

  43. Eason JD, Gonwa TA, Davis CL, Sung RS, Gerber D, Bloom RD. Proceedings of consensus conference on simultaneous liver kidney transplantation (SLK). Am J Transplant. 2008;8(11):2243–51. doi:10.1111/j.1600-6143.2008.02416.x.

    Article  CAS  PubMed  Google Scholar 

  44. Lawitz E, Sulkowski MS, Ghalib R, et al. Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders o pegylated interferon and ribavirin and treatment-naive patients: The COSMOS randomised study. Lancet. 2014;384(9956):1756–65. doi:10.1016/S0140-6736(14)61036-9.

    Article  CAS  PubMed  Google Scholar 

  45. Sorbera MA, Friedman ML, Cope R. New and emerging evidence on the use of second-generation direct acting antivirals for the treatment of hepatitis C virus in renal impairment. J Pharm Pract. 2016. pii: 0897190016632128. [Epub ahead of print].

    Google Scholar 

  46. Saxena V, Koraishy FM, Sise ME, et al. Safety and efficacy of sofosbuvir-containing regimens in hepatitis C infected patients with impaired renal function. Liver Int. 2016; doi:10.1111/liv.13102.

    PubMed  Google Scholar 

  47. Saxena V, Terrault NA. Treatment of hepatitis C infection in renal transplant recipients: the long wait is over. Am J Transplant. 2015; doi:10.1111/ajt.13697.

    Google Scholar 

  48. Sawinski D, Kaur N, Ajeti A, et al. Successful treatment of hepatitis C in renal transplant recipients with direct-acting antiviral agents. Am J Transplant. 2015; doi:10.1111/ajt.13620.

    Google Scholar 

  49. Hussein NR, Sidiq Z, Saleem M. Successful treatment of hepatitis C virus genotype 4 in renal transplant recipients with direct-acting antiviral agents. Am J Transplant. 2016; doi:10.1111/ajt.13767.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Recanati/Miller Transplantation Institute, The Mount Sinai Hospital, One Gustave L. Levy Place, Box 1104, New York, NY, 10029-6574, USA

    Antonios Arvelakis, Sander Florman & Ron Shapiro

Authors
  1. Antonios Arvelakis
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  2. Sander Florman
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  3. Ron Shapiro
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Correspondence to Antonios Arvelakis .

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Editors and Affiliations

  1. Transplantation Center, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA

    Bijan Eghtesad

  2. Department of Surgery, University of Chicago, Chicago, Illinois, USA

    John Fung

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Arvelakis, A., Florman, S., Shapiro, R. (2017). Kidney Transplantation in Cirrhotic Patients. In: Eghtesad, B., Fung, J. (eds) Surgical Procedures on the Cirrhotic Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-52396-5_17

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  • DOI: https://doi.org/10.1007/978-3-319-52396-5_17

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