MO954DONOR TYPE INFLUENCE IN EARLY POST KIDNEY TRASPLANTATION HYPERTRANSAMINASEMIA

Background and Aims The early increase in transaminases after kidney transplant (KT) is a frequent finding. It has been associated with the cross-talk produced between liver and kidney in ischemia-reperfusion situations. However, the influence of the donor type has not been evaluated. We analyze the incidence, relevance and possible correlations of postKT hypertransaminasemia. Method Retrospective study (2004-2018) to analyze the increase in serum AST/ALT during the first 3 months after KT in 119 KT recipients of deceased donors, either brain death (DBD n=59), controlled after cardiac death (cDCD n=21) or uncontrolled after cardiac death (uDCD n=39). All recipients received induction with thymoglobulin and maintenance immunosuppression with tacrolimus and mycophenolate. Results Recipients of uDCD group were younger, with a higher proportion of men and lower percentage of diabetics and retransplants. Delayed graft function duration was longer, although serum creatinine was similar at 3 months between groups. There were no differences between recipients in terms of past medical liver disease, postKT transfusion requirement or vasoactive drug use. There were also no differences in cumulative thymoglobulin dose, and uDCD recipients presented, as expected, lower levels of tacrolimus at one week postKT (Table). From all KT recipients, 37.3/45.3% presented with an increase in AST/ALT at 72 hours postKT. Regarding donor type, the percentage of recipients who experienced 72 hours postKT hypertransaminasemia was higher (69.2/82.1% in uDCD group vs 22/29.3% in DBD and 21.1/21.1% in cDCD, p<0.001). This liver function alteration resolved early, and one month after transplant, AST/ALT values in all groups returned to baseline (Figure). The multivariate analysis showed that uDCD recipients had x10 higher risk of developing early post-KT hypertransaminasemia than the other groups (for AST, OR 10.85 [2.463-47.826] and for ALT OR 11.15 [2.627-47.294]). However, when we tried to correlate this hypertransaminasemia with a prolonged delayed graft function (creatinine decrease> 14 days postKT) we did not find any association. Conclusion Early postKT hypertransaminasemia is a frequent and transient event that is related to the kidney donor type, being more frequent in recipients of donors in uncontrolled cardiac death.