{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:51:52Z","timestamp":1791348712534,"version":"4.3.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 &amp;gt; 5.0 mmol\/L) within three months of LT discharge. Univariable and multivariable Cox proportional hazards regression was used to identify predictors of hyperkalemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u20133.06); 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1924687","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:45:45Z","timestamp":1791348345000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Out of sight, out of mind, but at high risk: incidence, timing and risk factors for hyperkalemia after liver transplant discharge"],"prefix":"10.3389","volume":"17","author":[{"given":"Peyton","family":"Crest","sequence":"first","affiliation":[{"name":"Division of Transplant, Department of Surgery, University of California, San Francisco","place":["San Francisco, CA, United 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