Evidence map›Paper›PMID 31785069›Full record

ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2020

Chronic Kidney Disease in Liver Transplant Candidates: A Rising Burden Impacting Post-Liver Transplant Outcomes.

Giuseppe Cullaro, Elizabeth C Verna, Brian P Lee, Jennifer C Lai

Abstract read
In one paragraph

Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Machine learning-derived clinical phenotypes of ascites in cirrhosis: A multi-center latent class analysis with external validation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026
    Article
  3. Article
  4. Review
  5. Article
  6. Simultaneous Liver-Kidney Transplantation versus Liver Transplantation in End-Stage Liver Disease Patients with Kidney Dysfunction.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026
    Article
  7. Kidney-alone transplantation in prior SLK candidates: a national registry analysis.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Article
  8. Article
  9. Acute Kidney Injury in Patients With Cirrhosis and Chronic Kidney Disease: Results From the HRS-HARMONY Consortium.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Giuseppe CullaroDivision of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, CA.ORCID 0000-0002-2935-0245
Elizabeth C VernaCenter for Liver Disease and Transplantation, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Brian P LeeDivision of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, CA.ORCID 0000-0003-2108-1287
Jennifer C LaiDivision of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, CA.ORCID 0000-0003-2092-6380

Funding

NRSA Hepatology Training GrantT32DK060414 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Mandana Khalili, JACQUELYN J. MAHER · 2002 to 2026
$6.8M
Frailty and Functional Status in Older Liver Transplant PatientsK23AG048337 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LAI, JENNIFER C. · 2014 to 2018
$911k
NIA NIH HHS K23 AG048337NIDDK NIH HHS T32 DK060414
6 · The paper itself

Abstract

The burden of chronic kidney disease (CKD) is rising among patients with cirrhosis, though it is not known what impact this has had on outcomes after liver transplantation (LT). All patients listed for LT in the United States between 2002 and 2017 were analyzed, excluding those listed with Model for End-Stage Liver Disease (MELD) exceptions. The primary outcome was post-LT mortality. We defined pre-LT CKD as an estimated glomerular filtration rate <60 mL/minute for 90 days or ≥42 days of hemodialysis. Cox regression determined the association between pre-LT CKD and post-LT mortality. Of 78,640 LT candidates, the proportion with CKD among LT recipients increased from 7.8% in 2002 to 14.6% in 2017 (test for trend, P < 0.001). Among the 39,719 LT recipients, pre-LT CKD was significantly associated with post-LT mortality (hazard ratio [HR], 1.16; P < 0.001) even after adjusting for donor risk index (DRI), age, MELD, etiology, hepatic encephalopathy, simultaneous liver-kidney transplantation (SLKT), and diabetes. There was no mediating influence of SLKT on the effect of pre-LT CKD on post-LT survival (P > 0.05). Therefore, pre-LT CKD has a deleterious impact on post-LT outcomes, which is an impact that is not mediated through SLKT. These findings highlight the need for the identification of CKD when preventative measures are possible.

Indexed as

End Stage Liver DiseaseLiver TransplantationRenal Insufficiency, ChronicHumansRisk FactorsSeverity of Illness IndexTreatment OutcomeUnited States

Identifiers

PMID31785069
PMCPMC8056970

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.