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New research links liver health to kidney transplant success
Many kidney transplant recipients also live with conditions like high blood pressure, diabetes, or excess weight. New research suggests these same conditions may affect liver health after transplant—and, in turn, kidney transplant outcomes.
A new study from McGill University examined liver health in 650 people who received a kidney transplant between 2008 and 2020. Researchers focused on a condition called metabolic dysfunction-associated steatotic liver disease (MASLD), also known as fatty liver disease. MASLD occurs when too much fat builds up in the liver and is closely linked to conditions like diabetes and high blood pressure.
The study found that about 1 in 5 patients had MASLD at the time of their transplant. The condition also became more common over time: within five years of transplantation, more than 40 per cent of patients had MASLD. Many also showed signs of liver scarring (fibrosis), and by five years post-transplant, nearly 70 per cent had signs of advanced scarring.
Importantly, poorer liver health was linked to worse transplant outcomes. People with MASLD were more likely to lose their transplanted kidney or die, with the highest risks seen in those with advanced liver scarring. These patients had about three times the risk of transplant failure compared with people without scarring.
These findings matter because MASLD is often preventable and can sometimes be reversed if identified early. Managing weight, blood sugar, cholesterol, and blood pressure may help lower the risk of liver disease while also supporting kidney and heart health. The study also lays the groundwork for future research into treatments that could help protect the kidney, heart, and liver together.
Overall, this research highlights the close connection between liver and kidney health. Earlier screening and greater awareness may help identify liver problems sooner, reduce risks, and support long-term health and quality of life for people living with a kidney transplant.
This research was supported by The Kidney Foundation of Canada.
