Renal dysfunction (RD) is a frequent complication after orthotopic liver transplantation (OLT), and it has an unfavorable effect on the prognosis of OLT patients. The purpose of our study was to identify possible risk factors for RD and its impact on survival. The possible relations of pre-, peri-, and postoperative variables to early-onset renal dysfunction (ED) (within the 1st 3 months), lateonset renal dysfunction (LD) (between 3 and 6 months), and chronic renal dysfunction (CRD) (beyond 6 months) was analyzed. We studied 245 liver transplants in 241 patients. RD was found in 64.1% of these patients, and 69% of the patients with RD recovered. LD was found in 16.7% of the transplant patients. In the multivariate analysis, baseline serum creatinine, perioperative volume of transfused bank -red blood cells, Acute Physiology and Chronic Health Evaluation (APACHE) II score at intensive care unit (ICU) admission, and infection were associated with the development of RD. Overall mortality was 27.8% and for the RD group, it was 33.5%. LD, but not ED, was related to lower survival (together with graft dysfunction and APACHE II score at ICU admission). In conclusion, ED is frequent alter OLT and is related to preexisting RD, the volume of transfused bank --red blood cells during surgery, higher APACHE II score at ICU admission, and infection. In general, the prognosis for ED is good, in contrast with that of LD, which is associated with diminished survival. R enal dysfunction (RD) is a frequent postoperative occurrence for (OLT) orthotopic liver transplant patients. It is usually acute, appearing early after transplant, and a high number of patients recover from it, but in some cases, 1,2 RD persists and results in terminal renal disease.Serum creatinine determination is the most widely used, but perhaps not the most reliable, diagnostic method for assessing the renal function of patients with end-stage liver disease, which is associated with loss of muscular mass and creatinine synthesis. In addition, hyperbilirubinemia interferes with the measurement of serum creatinine. These facts result in an underestimation of renal function. The criteria for abnormal posttransplant renal function differ markedly. 3 -5 Moreover, there is no agreement on the assessment method or the creatinine level for these criteria. Therefore, studies on transplant renal function are influenced by this lack of consensus.Our aim was to identify the incidence, preoperative, intraoperative, and postoperative risk factors related to the development and recovery of early renal dysfunction (ED), and finally, to determine whether RD is an independent mortality factor.
