Acute Renal Failure After Liver Transplantation: Incidence, Etiology, Therapy, and Outcome

Junge, G.; Schewior, Lioba; Köhler, Sven; Neuhaus, R.; Langrehr, J. M.; Tullius, Stefan G.; Kahl, Andreas; Frei, Ulrich; Neuhaus, P.

doi:10.1016/j.transproceed.2006.01.074

Cited by 37 publications

(27 citation statements)

References 5 publications

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“…Variations between series can at least partly be explained by differences in criteria and the definitions used. The incidence of complete renal failure after OLT, requiring renal replacement therapy is lower and varies from 7% to 32% (18,31,(35)(36)(37). In the current study, the overall incidence of moderate and severe renal dysfunction at 1 week after transplantation was 9.6% and 11.5%, respectively.…”

Section: Discussionmentioning

confidence: 44%

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The Impact of Aprotinin on Renal Function After Liver Transplantation: An Analysis of 1043 Patients

Warnaar

Mallett²,

Boer

et al. 2007

American Journal of Transplantation

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Renal dysfunction is frequently seen after orthotopic liver transplantation (OLT).Aprotinin is an antifibrinolytic drug which reduces blood loss during OLT. Recent studies in cardiac surgery suggested a higher risk of postoperative renal complications when aprotinin is used. The impact of aprotinin on renal function after OLT, however, is unknown. In 1043 adults undergoing OLT, we compared postoperative renal function in patients who received aprotinin (n = 653) or not (n = 390). Using propensity score stratification (C-index 0.82) and multivariate regression analysis, aprotinin was identified as a risk factor for severe renal dysfunction within the first week, defined as increase in serum creatinine by ≥ 100% (OR = 1.97, 95% CI = 1.14-3.39; p = 0.02). No differences in renal function were noted at 30 and 365 days postoperatively. Moreover, no significant differences were found in the need for renal replacement therapy (OR = 1.52, 95% CI = 0.94-2.46; p = 0.11) or in 1-year patient survival rate (OR = 1.14, 95% CI = 0.73-1.77; p = 0.64) in patients who received aprotinin or not. In conclusion, aprotinin is associated with a higher risk of transient renal dysfunction in the first week after OLT, but not with a higher need for postoperative renal replacement therapy or an increased risk of mortality.

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Section: Discussionmentioning

confidence: 44%

“…Acute renal dysfunction is a frequent complication after OLT. The incidence ranges from 12% to 64% in different reports (20,(31)(32)(33)(34). Variations between series can at least partly be explained by differences in criteria and the definitions used.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Aprotinin on Renal Function After Liver Transplantation: An Analysis of 1043 Patients

Warnaar

Mallett²,

Boer

et al. 2007

American Journal of Transplantation

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“…The incidence of AKI is known to be high after LT in patients withelevated baseline creatinine levels, varying from 12% to 70% . Extensive research has suggested that many preoperative factors may favor the occurrence of AKI after OLT . Karapanagiotou et al, reported that MELD scores and baseline serum creatinine levels were significant risk factors for post‐LT AKI .…”

Section: Discussionmentioning

confidence: 99%

“…[46][47][48] Extensive research has suggested that many preoperative factors may favor the occurrence of AKI after OLT. [49][50][51] Karapanagiotou et al, reported that MELD scores and baseline serum creatinine levels were significant risk factors for post-LT AKI. 52 In our study, patients in the PCC group had higher serum creatinine levels and MELD scores during the preoperative period.…”

Section: Several Authors Have Compared Pcc and Ffp In Patients Under-mentioning

confidence: 99%

Utility of prothrombin complex concentrate as first‐line treatment modality of coagulopathy in patients undergoing liver transplantation: A propensity score‐matched study

Srivastava

Agarwal

Jha

et al. 2018

Clinical Transplantation

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Background Transfusion management during liver transplantation (LT) is aimed at reducing blood loss and allogeneic transfusion requirements. Although prothrombin complex concentrate (PCC) has been used satisfactorily in various bleeding disorders, studies on its safety, and efficacy during LT are limited. Methods A retrospective chart review of adult patients who underwent living donor LT at a single institute between October 2016 and January 2018 was carried out. The safety and efficacy of PCC in reducing transfusion requirements intraoperatively in patients who received PCC were compared with patients who did not receive PCC. A propensity score‐matching technique was used, at a 1:1 ratio, to remove selection bias. Results After completing the 1:1 propensity score‐matched analysis, 60 pairs of patients were identified. The use of PCC was associated with significantly decreased red blood cell transfusion requirements (6.2 ± 4.1 vs 8.23 ± 5.18, P < 0.001) and fresh frozen plasma transfusion requirements (2.6 ± 2 vs 6.18 ± 4.1, P < 0.001). The number of patients developing postoperative hemorrhagic complications was higher in the non‐PCC group. Conclusions During LT, the use of PCC led to decreased transfusion requirements. No thromboembolic complications related to PCC were noted in this series.

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“…Thus, the authors of this study can also conclusively assert that there is no role for CLKT for patients with HRS on short‐term dialysis pretransplant. We point out, however, that the incidence of ESRD progressing from acute renal failure in the non‐HRS population has been reportedly less than 1%,8–10 including 0.34% in our review. From this perspective, HRS patients are, at minimum, 6 times more likely to develop ESRD than their non‐HRS counterparts.…”

Section: Discussionmentioning

confidence: 65%

Letter to the editor

et al. 2009

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Acute Renal Failure After Liver Transplantation: Incidence, Etiology, Therapy, and Outcome

Cited by 37 publications

References 5 publications

The Impact of Aprotinin on Renal Function After Liver Transplantation: An Analysis of 1043 Patients

The Impact of Aprotinin on Renal Function After Liver Transplantation: An Analysis of 1043 Patients

Utility of prothrombin complex concentrate as first‐line treatment modality of coagulopathy in patients undergoing liver transplantation: A propensity score‐matched study

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