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Non-Viral Related Liver Enzymes Elevation After Kidney Transplantation

AUTHORS

Behzad Einollahi 1 , * , Alireza Ghadian 1 , Ebrahim Ghamar-Chehreh 2 , Seyed Moayed Alavian 3

AUTHORS INFORMATION

1 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

2 Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

3 Middle East Liver Diseases Center (MELD), Tehran, IR Iran

How to Cite: Einollahi B, Ghadian A, Ghamar-Chehreh E, Alavian S M. Non-Viral Related Liver Enzymes Elevation After Kidney Transplantation, Hepat Mon. 2014 ; 14(2):9036. doi: 10.5812/hepatmon.9036.

ARTICLE INFORMATION

Hepatitis Monthly: 14 (2); 9036
Published Online: February 4, 2014
Article Type: Research Article
Received: November 6, 2012
Accepted: September 30, 2013
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Abstract

Background: Liver enzymes elevations (LEE) can be observed after kidney transplantation due to multifactorial causes.

Objectives: We performed a retrospective study on 1589 kidney transplants, 971 male and 618 female, who were hepatitis B surface antigen (HBsAg) and hepatitis C virus-antibody (HCV Ab) negative, and had no other liver diseases, to detect the prevalence of LEE and its risk factors in these patients between May 2008 and May 2010.

Patients and methods: Liver enzymes and other biochemical parameters were measured in all recipients. Patients were divided into three groups, according to laboratory test time since transplantation: Group I, less than 3 months, Group II, 4 - 12 months after transplantation, and Group III, more than one year post-transplantation.

Results: The highest LEE was more frequent in older patients (P < 0.001) and male individuals (P < 0.001). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in patients who received kidneys from deceased donors (10.4% and 23.8%, respectively) as compared to living donor transplants (5.6% and 14.8%, respectively) (P < 0.001). The elevation of ALT was the liver enzyme abnormality after kidney transplantation with the highest prevalence (34.3%). The levels of ALT and AST were significantly elevated within the first 3 months after transplantation, followed by the 4-12 months period (P < 0.001). There was a reverse correlation between liver enzyme levels and renal allograft function in both univariate and linear regression analyses. This correlation increased over time. There was also a significant relation between cyclosporine blood levels and liver enzyme values in the univariate analysis. However, this relationship was attenuated over time. Elevated liver enzymes also correlated with anemia.

Conclusions: The LEE is a common finding among kidney transplant recipients. Serial monitoring of aminotransferases, particularly ALT, should be performed in all patients after kidney transplantation.

Keywords

Kidney Transplantation Cyclosporine Aspartate aminotransferase Alanine aminotransferase

© 2014, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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