Introduction After kidney transplantation, several factors should be checked to predict the risk of rejection. Liver enzymes are such predicting factors so liver function test abnormalities (LFTA) can consider the rejection possibility in kidney transplant recipients (KTR). Methods Through a retrospective cohort study, 659 KTR were studied. The source of all Grafts was from deceased donors. Amongst these cases, 67 patients showed a significant rise in creatinine as the rejection indication. Several liver indexes like alanine transaminase (ALT), aspartate transaminase (AST), direct bilirubin (Bil D), total bilirubin (Bil T), and liver ultrasound reports, gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), prothrombin time (PT) INR in addition to creatinine were examined for three-six post-transplant in KTR. Results Our study exposed that liver functional tests regularly had considerable statistical differences between KTR with creatinine increase and with no creatinine increase. Despite these differences between the two groups AST, ALT and ALP serum levels were still within the normal range in both groups. The same result was seen over the Bil D, and Bil T. Conclusions Liver function test abnormalities can not adequately predict the rejection. Some other elements should be taken into consideration like inflammation factors like erythrocyte sedimentation rate (ESR or sed rate), and C-reactive protein (CRP).

Background: Liver dysfunction is a rare complication with high mortality and morbidity rate in coronary artery bypass Grafting (CABG) surgery. Pulsatile blood flow probably maintains liver function during cardiopulmonary bypass (CPB). Methods: In this randomized clinical trial study, 68 patients who underwent CABG surgery were divided into two groups: pulsatile and non-pulsatile groups. We transferred continuous blood flow to pulsatile blood flow during proximal Graft by using cardiac contraction. Results: There was no significant difference in Alanine transaminase (ALT) and alkaline phosphatase (ALP) values at variable times between the groups. In addition, the procedure of ALT and ALP in the case and control groups was not significantly different in three days. There was no significant difference between AST values at variable times in two groups. However, the trend of AST in the case group was significantly increased while it was not significantly different in the control group during the next three postoperative days. Conclusion: It seems that hemodynamic stability is more important than type of blood flow in maintaining liver function.

Introduction: Hyperglycemia is common and a contributing factor to the undesirable outcomes in kidney transplant recipients. This study investigates the relationship of pretransplant blood glucose levels and the occurrence of delayed Graft function among kidney transplant recipients without a diagnosis diabetes mellitus before transplantation.Materials and Methods: Eighty-one patients on long-term hemodialysis with no history of clinically diagnosed diabetes mellitus were enrolled in this study. Correlation of the occurrence of delayed Graft function with age, gender, donor source, underlying cause of kidney failure, insulin resistance, and blood glucose levels before transplantation was evaluated.Results: There was a significant correlation between abnormal glucose metabolism categories and occurrence of delayed Graft function (P=.004). Logistic regression analysis showed that fasting blood glucose before kidney transplantation is an independent predictor of delayed Graft function immediately after transplantation (odds ratio=1.042, P=.04).Conclusions: Hyperglycemic patients have an increased risk for delayed Graft function and should be treated by more potent immune therapy and further restriction of blood glucose regulation in peritransplantation period.

Reduced Graft function (RGF) in donor renal transplant recipients is caused by oxidative damage due to extensive ischemia-reperfusion (I/R) injury during transplantation. Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker to detect tubular injury early after renal transplantation. N-acetylcysteine (NAC) is a potent antioxidant that can reduce I/R injury by improving oxidative damage. The aim of the present study is to assess the efficacy of NAC in improving Graft function and reducing renal tubular injury in deceased donor renal transplant recipients. A double-blind, randomized clinical trial was conducted on 50 deceased donor renal transplant recipients. The patients were randomized into two groups, receiving either 600 mg NAC twice daily, or placebo (days 0 to 5). Results were assessed based on the rate of RGF, levels of plasma NGAL (p-NGAL) and the estimated glomerular filtration rate (eGFR). The rate of RGF was significantly lower in the patients receiving NAC vs. placebo (21. 4% vs. 50%). The measurement of p-NGAL levels showed that the patients in the NAC group had significantly greater reduction of p-NGAL by both days 1 and 5 post-transplantation than those in the placebo group. A near steady-state eGFR level was reached by week 1 in the NAC group, however, the improvement of eGFR was significantly slower in the placebo group and a near steady-state was only achieved by week 4. NAC has promising potential in reducing tubular injury and improving Graft function, evidenced by significant reduction in the rate of RGF and levels of p-NGAL.