Renal dysfunction is a major risk factor for poorer outcome after liver transplantation.
Nevertheless, mechanisms of renal dysfunction in liver transplant recipients are not clearly
understood. Calcineurin inhibitors are generally perceived as the most important cause;
however the liver transplant procedure itself represents a major surgical / hemodynamic /
inflammatory trauma that - on its own - can cause renal dysfunction. Creatinine and
creatinine clearance are late markers of acute kidney injury and changes in these parameters
occur only after substantial injury has already occurred. Even a stable creatinine does not
exclude structural kidney damage.
A series of new markers of tissue injury have been identified and have the potential to
identify acute kidney injury better and earlier than creatinine and creatinine clearance. The
aim of this study is to determine whether and how liver transplantation affects these urinary
and plasma biomarkers and to study whether the changes in these biomarkers may predict later
changes in standard functional parameters (creatinine and creatinine clearance). For this
purpose, the urinary and plasma biomarkers, together with creatinine, will be determined
serially during the different phases of the liver transplant process and daily until day 5