Asian Transplantation Week 2017Liver TransplantationPretransplantation Cystatin C, but not Creatinine, Predicts 30-day Cardiovascular Events and Mortality in Liver Transplant Recipients With Normal Serum Creatinine Levels
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Patients and Methods
This is a retrospective study comprising patients undergoing living-donor LT at Asan Medical Center from May 2010 and October 2015. After excluding patients with sCr level >1.4 mg/dL, those younger than 18 years, or those with a previous history of cardiac surgery, a total of 1181 patients were enrolled. The patients were categorized into tertiles according to Cys-C and sCr levels. The primary end points were 30-day MACE and all-cause mortality observed until November 2015. The 30-day MACE was
Results
Among the total of 1181 LT recipients (mean age, 53 ± 8 years), 880 were males (75%) and 301 were females (25%). The median [interquartile range] Cys-C and sCr levels were 0.74 mg/L [0.62–0.89 mg/L] and 0.82 mg/dL [0.69–1.01 mg/dL], respectively. Among the total patients, 226 (19.1%) developed a 30-day MACE and 61 (5.2%) died during a mean follow-up of 25 ± 16 months after LT. Patients in the highest tertile of Cys-C were older, were females, had a higher chance of taking diuretics, and had
Discussion
In the current study, we showed the superiority of Cys-C as a potential prognostic factor, compared with sCr, analyzing in accurate postoperative risk stratification. The results showed that, after dividing the patients into tertiles according to Cys-C levels (≤0.74, 0.75–0.94, and ≥0.95 mg/L), higher Cys-C was an independent prognostic factor in predicting MACE. Furthermore, higher Cys-C was significantly and independently associated with a higher risk of all-cause mortality compared with sCr.
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