Abstract: FR-PO0979
Effect of Pretransplant Metabolic Dysfunction-Associated Steatotic Liver Disease on Post-Kidney Transplant Outcomes
Session Information
- Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Abdelkader, Ahmed I. Kamal, Medical University of South Carolina, Charleston, South Carolina, United States
- Ibrahim, Ahmed Aa, Medical University of South Carolina, Charleston, South Carolina, United States
- Elbagawy, Mariam Hany, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Cairo Governorate, Egypt
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a multisystem disease associated with cardiometabolic complications. While MASLD is highly prevalent among individuals with end-stage kidney disease (ESKD), its effect on outcomes following kidney transplantation (KT) remains poorly defined. This study aimed to evaluate whether MASLD is associated with adverse post-transplant outcomes.
Methods
We conducted a retrospective cohort study using the TriNetX database to identify adult patients (≥18 years) who underwent KT (2010-2020). Patients were stratified into two cohorts based on the presence or absence of MASLD. Individuals with a history of liver disease other than MASLD were excluded. Propensity score matching was performed to balance age, sex, body mass index (BMI), diabetes, hypertension, cardiovascular disease, and immunosuppressive medication use. Outcomes included new-onset diabetes mellitus, major adverse cardiovascular events (MACE), graft failure, infections, CKD stage 3b–5, dialysis, and all-cause mortality within 5 years post-transplant.
Results
A total of 1,570 kidney transplant (KT) recipients with MASLD were matched 1:1 to 1,570 recipients without MASLD. After matching, baseline characteristics were well balanced (standardized mean difference <0.1). Patients with MASLD had significantly higher rates of diabetes mellitus and major adverse cardiovascular events. Graft failure was more frequent in the MASLD group, as was CKD stage 3b–5. There were no significant differences in rates of post-transplant infection, dialysis initiation, or all-cause mortality.
Conclusion
MASLD prior to kidney transplantation is independently associated with increased risk of post-transplant metabolic complications, cardiovascular events, and CKD progression. These findings highlight the importance of incorporating MASLD into pre-transplant risk assessment and long-term care planning.