Prevalence and predictors of acute renal injury in liver transplant recipients

Transplant Proc. 2009 Oct;41(8):3123-5. doi: 10.1016/j.transproceed.2009.08.026.

Abstract

Renal failure is a major factor impacting liver transplant outcomes. Renal functional impairment predicts decreased survival, leading to increased morbidity and mortality. The aim of this study was to estimate the incidence, risk factors, and resolution of acute kidney injury (AKI) among liver transplant recipients during the operative hospital stay. We analyzed data from 99 orthotopic liver transplantations (OLT) performed at our center in 2008. Posttransplantation occurrence of AKI was defined as an increase in serum creatinine (SCr) concentration of 0.3 mg/dL or more, namely, 1.5-fold from baseline. AKI was observed among 31.31% of liver transplant recipients (n = 31). The mean increase in SCr was 2.49 +/- 0.78-fold from baseline. The mean posttransplant SCr level was 2.59 +/- 0.92 mg/dL. Renal replacement therapy was introduced to 16.12% (n = 5) liver recipients developing AKI. Among them, 2 subjects (6.45%) died. The mean SCr level at the time of discharge from the hospital was 1.17 +/- 0.57 mg/dL among the AKI group compared with 0.77 +/- 0.32 mg/dL among the group without AKI. Pretransplant renal impairment expressed by an elevated SCr concentration (relative risk [RR] = 1.25; P = .0386) and treatment with exogenous vasoconstrictors during the operation (RR = 2.27; P = .016) were identified as risk factors for developing AKI after liver transplantation.

MeSH terms

  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / epidemiology
  • Adult
  • Creatinine / blood
  • Diabetic Nephropathies / complications
  • Humans
  • Incidence
  • Liver Diseases / complications*
  • Liver Diseases / mortality
  • Liver Diseases / surgery*
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Prevalence
  • Risk Factors
  • Survival Analysis

Substances

  • Creatinine