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Risk of nephrogenic systemic fibrosis in liver transplantation patients.

AbstractOBJECTIVE:
The purpose of our study was to evaluate the exposure of our institution's liver transplantation population to gadolinium-based contrast agents and assess the rate of nephrogenic systemic fibrosis (NSF) within this unique group.
MATERIALS AND METHODS:
Institutional review board approval was obtained for a retrospective review of medical records of patients who had undergone liver transplantation at our institution between 1997 and 2008. Informed consent was not required. Demographic information, history of gadolinium-based contrast agent exposure, stage of chronic kidney disease (CKD), and evidence of NSF were recorded.
RESULTS:
A total of 2142 patients who had undergone liver transplantation at our institution between 1997 and 2008 were identified. Of this total, 33% (709/2142) had documented gadolinium-based contrast agent exposure peritransplantation. Patients in CKD1 and 2, CKD3, CKD4, and CKD5 comprised 50% (352/709), 28% (200/709), 8% (60/709), and 14% (97/709), respectively. Of patients in CKD5, 76% (74/97) required dialysis. Thorough review of all patients' medical records identified one biopsy-confirmed case of NSF in the 709 patients. This patient was also in CKD5 and required dialysis.
CONCLUSION:
Within our institution, only 0.1% (1/709) of all liver transplantation patients exposed to gadolinium-based contrast agents or 1.4% (1/74) of CKD5 patients requiring dialysis had biopsy proof of NSF. This incidence is consistent with the rate of NSF in all patients exposed to gadolinium-based contrast agents regardless of liver transplantation reported in the literature. Therefore, liver transplantation may not be an independent risk factor in development of NSF in patients exposed to gadolinium-based contrast agents.
AuthorsDaniel S Chow, Simin Bahrami, Steven S Raman, Sepehr Rotchel, James W Sayre, Ronald W Busuttil, David S Lu
JournalAJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 197 Issue 3 Pg. 658-62 (Sep 2011) ISSN: 1546-3141 [Electronic] United States
PMID21862808 (Publication Type: Journal Article)
Chemical References
  • Contrast Media
  • Gadolinium
Topics
  • Contrast Media (adverse effects)
  • Female
  • Gadolinium (adverse effects)
  • Humans
  • Incidence
  • Kidney Function Tests
  • Liver Transplantation
  • Male
  • Middle Aged
  • Nephrogenic Fibrosing Dermopathy (chemically induced, epidemiology)
  • Retrospective Studies
  • Risk Factors

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