Acute Kidney Injury After Liver Transplant: Incidence, Risk Factors, and Impact on Patient Outcomes

Arani, Reyhane Hizomi; Abbasi, Mohammad Reza; Mansournia, Mohammad Alì; Toosi, Mohsen Nasiri; Jafarian, Ali; Moosaie, Fatemeh; Karimi, Elaheh; Moazzeni, Seyyed Saeed; Shojamoradi, Mohammad Hossein

doi:10.6002/ect.2021.0300

Cited by 3 publications

(2 citation statements)

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“…These include avoiding unnecessary nephrotoxic medications, considering alternatives to radiocontrast, maintaining tight control of hemodynamic parameters, and avoiding hyperglycemia. In addition strategies to prevent or attenuate AKI in the perioperative LT patient or to facilitate recovery are urgently needed 1,2,4 .…”

Section: Discussionmentioning

confidence: 99%

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Acute Kidney Injury After Liver Transplantation: Incidence, Risk Factors, and Outcomes

Ersoy

Çekmen

Özdemirkan

et al. 2023

JoCASS

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Introduction: Although numerous risk factors for acute kidney injury (AKI) have been identified, their cumulative impact remains unclear. This study aimed to identify perioperative risk factors for early post-transplant AKI on patients and outcomes and to predict AKI using clinical variables. Material and Methods: A single-center, retrospective cohort study involving 34 pediatric patients and 31 adults who underwent LT between 2015 and 2017. Results: AKI occurred in 16 (47%) pediatric patients during the first-week post-LT with stage 1, stage 2, and stage 3 AKI frequencies of 43.8, 50, and 6.3%, respectively. Renal replacement therapy (RRT) was initiated in 18.8% of pediatric LT patients. Preoperative liver enzymes and the etiology of liver failure are the most critical factors affecting AKI in pediatric LT patients. AKI occurred in 15 (48%) adult patients during the first-week post-LT with stage 1, stage 2, and stage 3 AKI frequencies of 43%, 21%, and 21%, respectively. The requirement for RRT was seen in 43% of adult LT patients. There were also statistical differences between the two groups regarding the number of patients with preoperative kidney dysfunction (20-80%, p=.047) and mortality rates (6-31 %, p=.047). In adult patients who developed post-LT AKI compared with those who did not develop post-LT AKI, they had significantly higher levels of serum creatinine (sCr) (1.9±1.9 mg/dL vs. 0.7±0.1 mg/dL, p=.013), were given lower amounts of crystalloids (73±32 mL/kg vs. 106±33 mL/kg, p=.018) and had lower urine output (UO) intraoperatively (11±9 mL/kg vs. 20±9 mL/kg, p=.047). There was a higher mortality rate in adult patients with post-LT AKI (89 vs. 11%, p=.003). Conclusion: The results of our study contribute to raising awareness of the potential risk factors associated with preoperative evaluation, intraoperative and postoperative close follow-up, careful anesthesia management, and early onset of post-LT AKI.

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Section: Discussionmentioning

confidence: 99%

“…In the adult population, the incidence of AKI in the postoperative period has ranged from 4-94%. Several studies have demonstrated that post-AKI is a significant risk factor for poor prognosis post-LT outcomes 1,2 . As a result of severe AKI, 40.8 and 7.0% of LT adult patients require RRT.…”

Section: Introductionmentioning

confidence: 99%