Risk factors for acute kidney injury and 30-day mortality after liver transplantation

Barreto, Adller Gonçalves Costa; Daher, Elizabeth De Francesco; Silva, Geraldo Bezerra da; Garcia, José Huygens Parente; Magalhães, Clarissa Bentes de Araújo; Lima, José Milton Castro; Viana, Cyntia Ferreira Gomes; Pereira, Eanes Delgado Barros

doi:10.1016/s1665-2681(19)30763-x

Cited by 62 publications

(44 citation statements)

References 40 publications

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“…We described that increase of both cold and warm ischemia periods contributes to postoperative AKI when DBD grafts are used. These ischemia periods are both known factors to worsen hepatic IRI, but only WIT has earlier been linked to development of AKI . To our knowledge, CIT has not been related to AKI before.…”

Section: Discussionmentioning

confidence: 75%

The postreperfusion syndrome is associated with acute kidney injury following donation after brain death liver transplantation

et al. 2017

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Acute kidney injury (AKI) is frequently observed after donation after brain death (DBD) liver transplantation (LT) and associated with impaired recipient survival and chronic kidney disease. Hepatic ischemia/reperfusion injury (IRI) is suggested to be an important factor in this process. The postreperfusion syndrome (PRS) is the first manifestation of severe hepatic IRI directly after reperfusion. We performed a retrospective study on the relation between hepatic IRI and PRS and their impact on AKI in 155 DBD LT recipients. Severity of hepatic IRI was measured by peak postoperative AST levels and PRS was defined as >30% decrease in MAP ≥1 min within 5 min after reperfusion. AKI was observed in 39% of the recipients. AKI was significantly more observed in recipients with PRS (53% vs. 32%; P = 0.013). Median peak AST level was higher in recipients with PRS (1388 vs. 771 U/l; P < 0.001). Decrease in MAP after reperfusion correlated well with both severity of AKI (P = 0.012) and hepatic IRI (P < 0.001). Multiple logistic regression identified PRS as an independent factor for postoperative AKI (OR 2.28; 95% CI 1.06-4.99; P = 0.035). In conclusion, PRS reflects severe hepatic IRI and predicts AKI after DBD LT. PRS immediately after reperfusion is an early warning sign and creates opportunities to preserve postoperative renal function.

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Section: Discussionmentioning

confidence: 75%

The postreperfusion syndrome is associated with acute kidney injury following donation after brain death liver transplantation

et al. 2017

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“…There are many intraoperative risk factors related to the surgical technique and clinical conditions such as hemodynamic status and hydroelectrolytic disorders (9) . Postoperative risk factors include immunosuppressive drugs, infectious complications, use of antibiotics, sepsis, prolonged hypotension and use of radiological contrasts (10) . Preoperative risk factors were evaluated in the present study and seem to be related to the overall bad clinical condition of patients at the time they will undergo the liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, MELD scores, as a quantitative variable presented no significant difference between patients with or without AKI. However, MELD was more useful if used as a qualitative variable, associated with severe AKI (need for dialysis) (10) . A possibly cut-off level of 22 was useful to determine which patients were at risk of developing severe renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Risk Factors for Acute Kidney Injury After Liver Transplantation: Results From a Cross-Sectional Study in Northeast of Brazil

Junior

Cezar

Meneses

et al. 2018

Arq. Gastroenterol.

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“…Исследование H. Aksu Erdost et al [36] показало, что при MELD более 20 баллов у реципиента повышается риск ОПП после ТП. Вирусный гепатит у реципиента, время тепловой ишемии донорской печени и высокий уровень лактата в сыворотке крови до ТП оказались факторами риска ОПП в исследовании A.G. Barreto et al [14]. Кроме того, факторами, предрасполагающими к ОПП, являются: женский пол, масса тела более 100 кг, неалкогольный стеатогепатит, тяжесть заболевания нативной печени [25].…”

Section: дооперационные факторы риска у реципиентаunclassified

“…Оно чаще наблюдается при использовании печени от асистолических доноров и обычно развивается в ранние сроки после ТП -от шести часов до конца первых суток после реперфузии [13]. Позднее начало ОПП наблюдается у меньшего числа пациентов [14]. Острое по вреждение почек развивается после ТП не только от посмертных, но и от живых доноров [15][16][17].…”

Section: Introductionunclassified

New trends in the study of post-transplant acute kidney injury after liver transplantation

Ильинский

Цирульникова

2020

RJTAO

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Acute kidney injury (AKI) after liver transplantation (LT) is a pressing issue and remains the focus of many researchers. The etiology of AKI is multifactorial, but the main one is ischemia-reperfusion injury to the liver transplant. Numerous preoperative, intraoperative and postoperative risk factors contribute to the development of AKI. The use of standard classifications, such as AKIN, RIFLE and KDIGO, has improved post-transplant AKI diagnosis. However, determination of creatinine levels in the blood enables AKI diagnosis only in the later stages of this syndrome. Therefore, studies are currently underway to find ways of early diagnosis of AKI using biomarkers. Transition to a molecular level not only improves accuracy but also facilitates early diagnosis of AKI. Currently, the diagnostic capabilities of neutrophil gelatinase-associated lipocalin (NGAL) are the most investigated. To date, there are no known measures of preventing post-transplant AKI. Moreover, treatment of this condition cannot be considered satisfactory. Even a mild post-transplant AKI can be fatal. In severe AKI, where renal replacement therapy is used, there is a risk of death in the intensive care unit. More than half of AKI patients develop chronic kidney disease requiring chronic hemodialysis.

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Risk factors for acute kidney injury and 30-day mortality after liver transplantation

Cited by 62 publications

References 40 publications

The postreperfusion syndrome is associated with acute kidney injury following donation after brain death liver transplantation

The postreperfusion syndrome is associated with acute kidney injury following donation after brain death liver transplantation

Preoperative Risk Factors for Acute Kidney Injury After Liver Transplantation: Results From a Cross-Sectional Study in Northeast of Brazil

New trends in the study of post-transplant acute kidney injury after liver transplantation

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