Incidence of Early Acute Kidney Injury in Lung Transplant Patients: A Single-Center Experience

Balcı, Merih Kalamanoğlu; Vayvada, Mustafa; Saltürk, Cüneyt; Kutlu, Cemal Asım; Arı, Elif

doi:10.1016/j.transproceed.2017.01.031

Cited by 21 publications

(39 citation statements)

References 22 publications

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“…Up to 68% of lung transplant recipients develop AKI, which has been associated with increased one-year mortality, length of hospital stay, higher resource utilization, and related health care burden [10,11,12,13,14,15,16,17,18,19,20,21,22]. Though survival following lung transplantation has improved over the past few decades, morbidity and mortality related to AKI after lung transplantation and resultant progressive CKD remain relatively high and is a cause for increasing concern [16,23,24,25]. The incidence of AKI following lung transplantation varies widely, estimated to be as high as two-thirds of recipients, with up to 5% to 8% requiring dialysis in the initial few months post lung transplantation [11,13,14,15,21,24,26,27,28,29].…”

Section: Introductionmentioning

confidence: 99%

“…Though survival following lung transplantation has improved over the past few decades, morbidity and mortality related to AKI after lung transplantation and resultant progressive CKD remain relatively high and is a cause for increasing concern [16,23,24,25]. The incidence of AKI following lung transplantation varies widely, estimated to be as high as two-thirds of recipients, with up to 5% to 8% requiring dialysis in the initial few months post lung transplantation [11,13,14,15,21,24,26,27,28,29]. Differences in the definition of AKI may account for the variance of incidence of post-lung-transplant AKI [28].…”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Lertjitbanjong

Cheungpasitporn

O'Corragain

et al. 2019

JCM

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Background: Lung transplantation has been increasingly performed worldwide and is considered an effective therapy for patients with various causes of end-stage lung diseases. We performed a systematic review to assess the incidence and impact of acute kidney injury (AKI) and severe AKI requiring renal replacement therapy (RRT) in patients after lung transplantation. Methods: A literature search was conducted utilizing Ovid MEDLINE, EMBASE, and Cochrane Database from inception through June 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring RRT, and mortality risk of AKI among patients after lung transplantation. Pooled incidence and odds ratios (ORs) with 95% confidence interval (CI) were obtained using random-effects meta-analysis. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42019134095). Results: A total of 26 cohort studies with a total of 40,592 patients after lung transplantation were enrolled. Overall, the pooled estimated incidence rates of AKI (by standard AKI definitions) and severe AKI requiring RRT following lung transplantation were 52.5% (95% CI: 45.8–59.1%) and 9.3% (95% CI: 7.6–11.4%). Meta-regression analysis demonstrated that the year of study did not significantly affect the incidence of AKI (p = 0.22) and severe AKI requiring RRT (p = 0.68). The pooled ORs of in-hospital mortality in patients after lung transplantation with AKI and severe AKI requiring RRT were 2.75 (95% CI, 1.18–6.41) and 10.89 (95% CI, 5.03–23.58). At five years, the pooled ORs of mortality among patients after lung transplantation with AKI and severe AKI requiring RRT were 1.47 (95% CI, 1.11–1.94) and 4.79 (95% CI, 3.58–6.40), respectively. Conclusion: The overall estimated incidence rates of AKI and severe AKI requiring RRT in patients after lung transplantation are 52.5% and 9.3%, respectively. Despite advances in therapy, the incidence of AKI in patients after lung transplantation does not seem to have decreased. In addition, AKI after lung transplantation is significantly associated with reduced short-term and long-term survival.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Lertjitbanjong

Cheungpasitporn

O'Corragain

et al. 2019

JCM

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“…Furthermore, uid overload has been demonstrated to be associated with adverse kidney events in critically ill patients (15,16). The relationship between hypotension and AKI is well known (14,17), however, when patients with hypotension during surgery need uid resuscitation, we must manage the amount of uid more accurately to avoid overcorrection.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence, Risk Factors and Prognosis of Acute Kidney Injury after Lung Transplantation: A Single-center Cohort Study in China

Sang

Chen

Nong

et al. 2020

Preprint

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Background To evaluate the incidence, risk factors, and prognosis of acute kidney injury (AKI) after lung transplantation (LTx). Methods Records of patients who underwent LTx in a single center were retrospectively reviewed. The prevalence of post-transplant AKI, the use of continuous renal replacement therapy (CRRT), and the risk factors for AKI were investigated. The impact of AKI and CRRT on short-term outcomes and long-term survival was measured. Results 148 patients were included with 67 cases developed post-operative AKI. 31 patients underwent CRRT; the percentage of CRRT was 6.2%, 0%, 10% and 86.2% in no-AKI, and stage 1, 2 and 3 AKI, respectively. Patients with AKI had significantly higher ICU mortality and in-hospital mortality. The 1-year post-LTx survival rate of patients with AKI was 47.8%, significantly lower than those without (74.1%). There was no difference in the 1-year survival rate of those with stage 1 and stage 2 AKI, but patients with stage 3 AKI showed the worst survival. Patients who underwent CRRT had an inferior survival outcome (9.7% vs. 76.1%, P < 0.05). We found that higher APACHE II score (OR 1.082, P = 0.009), and higher intraoperative fluid balance (OR 1.001, P = 0.012) were independent risk factors, and female (OR 2.539) and pulmonary hypertension (OR 2.869) were potential risk factors for post-LTx AKI. A prediction model integration of the above factors showed a good concordance with actual risks and had a C-index of 0.76 (95% CI, 0.66–0.87). Conclusion Severe AKI which needed CRRT had a negative impact on the short-term and long-term outcomes.

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“…LT is established for patients with a variety of end-stage lung diseases to improve quality of life and prolong life expectancy. [13,14] Although it is a lifesaving measure, LT is associated with well-known postoperative complications that contribute to critical morbidity and mortality. [13–15] Among them, postoperative AKI reduces survival rate of patient and graft.…”

Section: Discussionmentioning

confidence: 99%

Inhaled nitric oxide therapy was not associated with postoperative acute kidney injury in patients undergoing lung transplantation

Son

et al. 2018

Medicine

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Inhaled nitric oxide (iNO) therapy is commonly used in lung transplantation (LT) recipients during the perioperative periods. However, previous studies report that the use of iNO may increase the risk of renal dysfunction. Post-LT acute kidney injury (AKI) can lead to critical situations, including prolonged intensive care unit or hospital stays and increased morbidity and mortality. Accordingly, the aim of this study was to investigate the relationship between iNO therapy and incidence of post-LT AKI in LT recipients.The medical data of 36 patients who underwent LT surgery from January 2012 to July 2017 in a single university hospital setting were retrospectively collected and analyzed. Patients were divided into 2 groups: iNO (n = 14) and control (n = 19). The demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Patients were categorized according to changes in plasma creatinine (Cr) concentration levels within 48 hours after LT using Acute Kidney Injury Network criteria.There was no significant difference in the occurrence (P = .13) and severity (P = .9) of post-LT AKI between iNO and control groups. The mean serum Cr levels after surgery were 0.91 ± 0.44 and 0.81 ± 0.37 mg/dL in the iNO and control groups, respectively (P = .50).AKI plays a critical role in the prognosis of LT recipients. Our results revealed that iNO therapy was not associated with the incidence of post-LT AKI. Therefore, if iNO treatment is indicated, active use under close monitoring of renal function is recommended in LT-patients concerned about AKI after surgery.

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Incidence of Early Acute Kidney Injury in Lung Transplant Patients: A Single-Center Experience

Cited by 21 publications

References 22 publications

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

The Prevalence, Risk Factors and Prognosis of Acute Kidney Injury after Lung Transplantation: A Single-center Cohort Study in China

Inhaled nitric oxide therapy was not associated with postoperative acute kidney injury in patients undergoing lung transplantation

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