Kosuta I, Ostojic A, Vujaklija Brajkovic A, Babel J, Simunov B, Sremac M, Mrzljak A. Shifting perspectives in liver diseases after kidney transplantation. World J Hepatol 2023; 15(7): 883-896 [PMID: 37547033 DOI: 10.4254/wjh.v15.i7.883]
Corresponding Author of This Article
Iva Kosuta, MD, PhD, Attending Doctor, Department of Intensive Care Medicine, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia. ivakosuta@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jul 27, 2023; 15(7): 883-896 Published online Jul 27, 2023. doi: 10.4254/wjh.v15.i7.883
Shifting perspectives in liver diseases after kidney transplantation
Iva Kosuta, Ana Ostojic, Ana Vujaklija Brajkovic, Jaksa Babel, Bojana Simunov, Maja Sremac, Anna Mrzljak
Iva Kosuta, Ana Vujaklija Brajkovic, Jaksa Babel, Department of Intensive Care Medicine, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Ana Ostojic, Maja Sremac, Anna Mrzljak, Department of Gastroenterology and Hepatology, Liver Transplant Center, University Hospital Centre Zagreb, Zagreb 10000, Croatia
Ana Vujaklija Brajkovic, Anna Mrzljak, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Bojana Simunov, Department of Nephrology, University Hospital Merkur, Zagreb 10000, Croatia
Author contributions: Kosuta I contributed with literature review, analysis, and interpretation of data and drafting of the initial manuscript; Ostojic A, Vujaklija Brajkovic A, Babel J, Simunov B and Sremac M collected the data and drafted the initial manuscript; Mrzljak A contributed to the conception and design of the manuscript, making a critical revision of the initial manuscript and by making final approval of the article; All the authors approved the final version of the manuscript.
Supported bythe Croatian Science Foundation, Project: Emerging and Neglected Hepatotropic Viruses after Solid Organ and Hematopoietic Stem Cell Transplantation, No. IP-2020-02-7407 (to Mrzljak A).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Iva Kosuta, MD, PhD, Attending Doctor, Department of Intensive Care Medicine, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia. ivakosuta@gmail.com
Received: March 26, 2023 Peer-review started: March 26, 2023 First decision: April 28, 2023 Revised: May 15, 2023 Accepted: June 6, 2023 Article in press: June 6, 2023 Published online: July 27, 2023
Abstract
Liver diseases after kidney transplantation range from mild biochemical abnormalities to severe hepatitis or cirrhosis. The causes are diverse and mainly associated with hepatotropic viruses, drug toxicity and metabolic disorders. Over the past decade, the aetiology of liver disease in kidney recipients has changed significantly. These relates to the use of direct-acting antiviral agents against hepatitis C virus, the increasing availability of vaccination against hepatitis B and a better understanding of drug-induced hepatotoxicity. In addition, the emergence of the severe acute respiratory syndrome coronavirus 2 pandemic has brought new challenges to kidney recipients. This review aims to provide healthcare professionals with a comprehensive understanding of recent advances in the management of liver complications in kidney recipients and to enable them to make informed decisions regarding the risks and impact of liver disease in this population.
Core Tip: Liver disease is a common complication after kidney transplantation and can present in a variety of forms, from asymptomatic biochemical abnormalities to fibrosis/cirrhosis/decompensation/malignancy. Early recognition and referral to a hepatologist are crucial for effective treatment, as they can otherwise lead to impaired quality of life and increased morbidity. Screening of kidney transplant recipients for liver disease, including viral disease, metabolic disorders and drug toxicity, should be prioritised by healthcare providers.
