{
  "abstract": "Background: Hyperkalemia occurs in liver transplant (LT) recipients due to calcineurin inhibitor initiation and post-operative renal dysfunction and is associated with significant patient morbidity and resource expenditures. Little is known about the prevalence and timing of hyperkalemia after LT discharge.\n\nMethods: Adults undergoing LT between 1/2022-12/2024 at a single transplant center were included, excluding simultaneous heart-liver transplant recipients and patients who died before discharge. The primary exposure was time to hyperkalemia (serum potassium > 5.0 mmol/L) within three months of LT discharge. Univariable and multivariable Cox proportional hazards regression was used to identify predictors of hyperkalemia.\n\nResults: Of 544 patients, 268 (49%) developed hyperkalemia within three months following LT discharge. Compared to patients without hyperkalemia, those who developed hyperkalemia were more likely to have diabetes mellitus (30% vs 20%, p=0.01) and higher laboratory MELD scores (29 vs 24, p=0.02). The median time to the first hyperkalemia episode was 11 days (IQR 5-28) after LT discharge, with the highest incidence occurring during the first week after discharge. 110 patients (20%) had hyperkalemia documented during readmission. On multivariable Cox regression, CKD stages 3a (aHR 1.63, 95% CI 1.11-2.40), 3b (aHR 2.38, 95% CI 1.51-3.74), and 5 (aHR 2.01, 95% CI 1.32–3.06); one week pre-transplant potassium (aHR 1.52, 95% CI 1.24-1.84); and discharge potassium (aHR 1.63, 95% CI 1.24-2.16) were independently associated with hyperkalemia.\n\nConclusion: Hyperkalemia is common within the first three months following LT discharge. These findings support the development of risk-stratified surveillance and management guidelines to reduce hyperkalemia-related morbidity and healthcare utilization. Given the cost and access barriers associated with outpatient hyperkalemia treatment, targeted interventions are needed to safeguard patients after discharge.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Transplant, Department of Surgery, University of California, San Francisco",
    "University of California, San Francisco School of Medicine",
    "Department of Anesthesia and Perioperative Care, University of California, San Francisco"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Peyton Crest"
    },
    {
      "affs": [
        0
      ],
      "name": "Holland Stacey"
    },
    {
      "affs": [
        1
      ],
      "name": "Akshara Vykunta"
    },
    {
      "affs": [
        1
      ],
      "name": "Ella Atsavapranee"
    },
    {
      "affs": [
        1
      ],
      "name": "Kevin Kachi Ogbonna"
    },
    {
      "affs": [
        1
      ],
      "name": "Kara Ushijima"
    },
    {
      "affs": [
        1
      ],
      "name": "Liliana Espinosa"
    },
    {
      "affs": [
        1
      ],
      "name": "Nathan Robbins"
    },
    {
      "affs": [
        2
      ],
      "name": "Dieter Adelmann"
    },
    {
      "affs": [
        0
      ],
      "name": "Garrett R. Roll"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4kj4xpyyrg9j9.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1924687",
  "fulltext_url": "https://europepmc.org/articles/PMC13682998",
  "id": "4kj4xpyyrg9j9",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1924687/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Potassium and Related Disorders"
    ]
  ],
  "openalex": "W7220861147",
  "pdf_url": "https://europepmc.org/articles/PMC13682998?pdf=render",
  "pmcid": "PMC13682998",
  "pmid": "42908604",
  "published": "2026-10-07",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4kj4xpyyrg9j9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1924687",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1924687/full"
    },
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42908604",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908604"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Out of sight, out of mind, but at high risk: incidence, timing and risk factors for hyperkalemia after liver transplant discharge",
  "title_text": "Out of sight, out of mind, but at high risk: incidence, timing and risk factors for hyperkalemia after liver transplant discharge",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/4kj4xpyyrg9j9",
  "venue": "Frontiers in Immunology",
  "versions": []
}