Abstract: TH-PO786
Association between Noninvasive Liver Biomarkers and Graft Outcomes in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - 2
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Lee, Jaeyun, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
- Baek, Chung Hee, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
- Kim, Hyosang, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
- Jung, Chan-Young, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
Background
Though studies have suggested that metabolic risk profiles may be prognostic factors in kidney transplant recipients (KTRs), the prognostic significance of fatty liver severity, a known surrogate of metabolic risk, in KTRs has not been previously investigated. This study aimed to evaluate the association between non-invasive liver biomarkers and graft outcomes in KTRs.
Methods
Patients who underwent deceased or living donor kidney transplantation (KT) between January 2000 and December 2022 were collected. Hepatic fibrosis burdens of KTRs were assessed using the Fibrosis-4 (FIB-4) score and the non-alcoholic fatty liver disease fibrosis score (NFS), one month after KT. The primary outcome was a composite of 50% estimated glomerular filtration rate (eGFR) decline and graft failure. Secondary outcomes included individual outcomes of 50% eGFR decline, graft failure, and acute rejection including both cellular and antibody-mediated rejection.
Results
A total of 3,092 patients were grouped into three categories according to FIB-4 scores. During a mean follow-up of 6.0 years, the composite outcome occurred in 519 (2.8/100 person-years) patients. For the secondary outcomes, incidence rates for 50% eGFR decline, acute rejection, and graft failure were 2.3, 2.3, and 1.5 per 100 person-years, respectively. The cumulative incidences of all outcomes were higher in patients with higher FIB-4 scores (all P <0.05; Fig 1). In multivariate Cox models, the highest score group (FIB-4≥2.67) had a 2.05-fold (95% confidence interval [CI], 1.44-2.91; P<0.001) higher risk of the composite outcome compared to the lowest score group (FIB-4<1.30). The highest score group showed higher risk of the secondary outcomes compared to the lowest score group, with risk ratios of 1.75 (95% CI, 1.16-2.66), 1.62 (95% CI, 1.06-2.46), 2.23 (95% CI, 1.43-3.46). Similar findings were observed for NFS.
Conclusion
Higher liver fibrosis scores were associated with unfavorable graft outcomes in KTRs.
Figure 1. Cumulative incidence of graft outcomes according to FIB-4 score