Early hypertransaminasemia after kidney transplantation: significance and evolution according to donor type

Solà Porta, Eulàlia; Redondo Pachón, María Dolores; Arias Cabrales, Carlos Enrique; Navazo, Diego; Buxeda, Anna; Burballa Tàrrega, Carla, 1988-; Crespo Barrio, Marta; García Retortillo, Montserrat; Pascual Santos, Julio; Pérez-Sáez, María José

doi:http://dx.doi.org/10.3390/jcm10215168

Early hypertransaminasemia after kidney transplantation: significance and evolution according to donor type

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Solà-Porta E, Redondo-Pachón D, Arias-Cabrales C, Navazo D, Buxeda A, Burballa C, et al. Early hypertransaminasemia after kidney transplantation: significance and evolution according to donor type. J Clin Med. 2021 Nov 4; 10(21): 5168. DOI: 10.3390/jcm10215168

Abstract

Early hypertransaminasemia after kidney transplantation (KT) is frequent. It has been associated with the crosstalk produced between the liver and the kidney in ischemia-reperfusion situations. However, the influence of the donor type has not been evaluated. We present a retrospective study analyzing the increase in serum aspartate aminotransferase/alanine aminotransferase (AST/ALT) during the first three months post-KT in 151 recipients who received thymoglobulin as induction therapy, either from brain-death donors (DBD, n = 75), controlled circulatory death donors (cDCD, n = 33), or uncontrolled DCD (uDCD, n = 43). Eighty-five KT recipients from DBD who received basiliximab were included as controls. From KT recipients who received thymoglobulin, 33.6/43.4% presented with an increase in AST/ALT at 72 h post-KT, respectively. Regarding donor type, the percentage of recipients who experienced 72 h post-KT hypertransaminasemia was higher in uDCD group (65.1/83.7% vs. 20.3/26% in DBD and 20.7/27.6% in cDCD, p < 0.001). Within the control group, 9.4/12.9% of patients presented with AST/ALT elevation. One month after transplant, AST/ALT values returned to baseline in all groups. The multivariate analysis showed that uDCD recipients had 6- to 12-fold higher risk of developing early post-KT hypertransaminasemia. Early post-KT hypertransaminasemia is a frequent and transient event related to the kidney donor type, being more frequent in uDCD recipients.