Implications of Hyponatremia in Liver Transplantation

Çimen, Sertaç; Güler, Sanem; Ayloo, Subhashini; Molinari, Michele

doi:10.3390/jcm4010066

Cited by 5 publications

(3 citation statements)

References 38 publications

(72 reference statements)

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“…[7,9,34] Our finding that preoperative hypoalbuminemia is associated with postoperative AKI agrees with previous findings in the LT population [35] as well as other surgical populations. [36][37][38][39] Other preoperative variables, including hyponatremia [40] and etiology of liver failure, [25] have been shown to influence postoperative AKI; however, these were not found to be significant in our study. This could be secondary to differences in patient population or, potentially, results from a redundancy in preoperative variables, leading to the selection of some variables and nonselection of others by our methodology.…”

Section: Concordance With Previous Studiescontrasting

confidence: 78%

Intraoperative risk factors of acute kidney injury after liver transplantation

et al. 2022

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Acute kidney injury (AKI) is one of the most common complications of liver transplantation (LT). We examined the impact of intraoperative management on risk for AKI following LT. In this retrospective observational study, we linked data from the electronic health record with standardized transplant outcomes.Our primary outcome was stage 2 or 3 AKI as defined by Kidney Disease Improving Global Outcomes guidelines within the first 7 days of LT. We used logistic regression models to test the hypothesis that the addition of intraoperative variables, including inotropic/vasopressor administration, transfusion requirements, and hemodynamic markers improves our ability to predict AKI following LT. We also examined the impact of postoperative AKI on mortality.Of the 598 adult primary LT recipients included in our study, 43% (n = 255) were diagnosed with AKI within the first 7 postoperative days. Several preoperative and intraoperative variables including (1) electrolyte/acid-base balance disorder (International Classification of Diseases, Ninth Revision codes

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Section: Concordance With Previous Studiescontrasting

confidence: 78%

Intraoperative risk factors of acute kidney injury after liver transplantation

et al. 2022

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“…(17). Additionally, patients with liver cirrhosis have low levels of procoagulant factors, resulting in a new, rebalanced hemostasis (18). However, whether these acquired hemostatic alterations facilitate the PVT or alter the post-transplant outcome has not yet been confirmed (19,20).…”

Section: Discussionmentioning

confidence: 99%

Impact of Portal Vein Thrombosis on the Outcomes of Liver Transplantation

Eren

Dınçkan

2023

Osmangazi̇ Journal of Medicine

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Portal vein thrombosis (PVT) occurs in up to 17.9% of patients awaiting liver transplantation. It may impact post-liver transplantation survival negatively. The liver transplant procedures performed in our transplant center between January 2020 and June 2021 were screened. Data were collected retrospectively from the electronic folder system. Data, including causes of mortality, recipient gender, age, transplant indication, presence of hepatocellular carcinoma, rejection episodes, number of days in the intensive care unit, hospitalization duration, and complications, were recorded. Patients with no PVT constituted the control group. Patients with PVT were considered as the study group. Student’s t-test and the Mann-Whitney U test were used to evaluate the significance of the difference between study groups. Overall, 223 liver transplants were performed within the study period. Three re-transplants were excluded from the study. The analysis of 220 liver transplant patients revealed that 18.2% (n=20) of the patients presented with a PVT before liver transplantation. Patients with PVT had a higher rate of non-alcoholic steatohepatitis as an indication of a liver transplant. In addition, the presence of PVT significantly increased surgical mortality and early rejection rates. In correlation with this, the intensive care unit stay was longer in the patient group with PVT. Although the early surgical mortality post-liver transplant was higher in the group with PVT, the underlying variables could not be identified in this study. Nevertheless, the late mortality rates were not higher in patients with PVT following liver transplantation

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“…Severe pre-transplant hyponatremia has recently been identified as correlating with a high incidence of post-operative AKI. The pathophysiological mechanisms are still under debate, and it is unclear whether hyponatremia is an independent risk factor for post-operative AKI or a consequence of pre-clinical renal impairment that went undetected prior to LT 34 .…”

Section: Pre-operative Risk Factorsmentioning

confidence: 99%

Acute kidney injury in liver transplant candidates: a position paper on behalf of the Liver Intensive Care Group of Europe

Angeli¹,

Bezinover

Biancofiore³

et al. 2017

Minerva Anestesiol

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Acute kidney injury (AKI) is associated with high perioperative mortality. A series of AKI research breakthroughs are worth mentioning. First, in 2003, serum and urine biomarkers specific to AKI were identified. These biomarkers have contributed to early detection, prevention, and treatment of AKI. In 2004, AKI severity was defined with the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, which was developed by the International Consensus Conference Workgroup of the Acute Dialysis Quality Initiative. In 2007, the definition was further refined by the AKI network classification, and in 2012 Kidney Disease Improving Global Outcomes (KDIGO) standardized the RIFLE criteria into AKI stages I to III. Finally, a definition of AKI specifically for patients with end-stage liver disease (ESLD) was established by the International Club of Ascites (ICA) in 2015. Overall, these definitions and standardized criteria provide a foundation for systematic management of patients with AKI.Another important challenge over the last 20 years in the management of AKI is establishing the optimum timing to initiate renal replacement therapy (RRT). Previous evaluations did not support the use of RRT at the early stage of kidney dysfunction. Although a number of retrospective studies published in the last 10 to 15 years support using RRT at an early stage for patients with AKI, the exact indication for RRT remains unclear.

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Implications of Hyponatremia in Liver Transplantation

Cited by 5 publications

References 38 publications

Intraoperative risk factors of acute kidney injury after liver transplantation

Intraoperative risk factors of acute kidney injury after liver transplantation

Impact of Portal Vein Thrombosis on the Outcomes of Liver Transplantation

Acute kidney injury in liver transplant candidates: a position paper on behalf of the Liver Intensive Care Group of Europe

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