Postoperative acute kidney injury in living donor liver transplantation recipients

2017 ◽  
Vol 41 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Hakan K. Atalan ◽  
Bulent Gucyetmez ◽  
Serdar Aslan ◽  
Serafettin Yazar ◽  
Kamil Y. Polat
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Blood Loss ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Kidney Injury ◽  
Intraoperative Blood Loss ◽  
Donor Liver ◽  
Donor Liver Transplantation

Purpose: There are many risk factors for postoperative acute kidney injury in liver transplantation. The aim of this study is to investigate the risk factors for postoperative acute kidney injury in living donor liver transplantation recipients. Methods: 220 living donor liver transplantation recipients were retrospectively evaluated in the study. According to the Kidney Disease Improving Global Outcomes Guidelines, acute kidney injury in postoperative day 7 was investigated for all patients. The patient’s demographic data, preoperative and intraoperative parameters, and outcomes were recorded. Results: Acute kidney injury was found in 27 (12.3%) recipients. In recipients with acute kidney injury, female population, model for end-stage liver disease score, norepinephrine requirement, duration of mean arterial pressure less than 60 mmHg, the usage of gelatin and erythrocyte suspension and blood loss were significantly higher than recipients with nonacute kidney injury (for all p<0.05). In multivariate analyses, the likelihood of acute kidney injury on postoperative day 7 were increased 2.8-fold (1.1-7.0), 2.7-fold (1.02-7.3), 3.4-fold (1.2-9.9) and 5.1-fold (1.7-15.0) by postoperative day 7, serum tacrolimus level ≥10.2 ng dL−1, intraoperative blood loss ≥14.5 mL kg−1, the usage of gelatin >5 mL kg−1 and duration of MAP less than 60 mmHg ≥5.5 minutes respectively (for all p<0.05). Conclusions: In living donor liver transplantation recipients, serum tacrolimus levels, intraoperative blood loss, hypotension period and the usage of gelatin may be risk factors for acute kidney injury in the early postoperative period.

scholarly journals Predictive utility of fibrinogen in acute kidney injury in living donor liver transplantation: A propensity score-matching analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252715
Author(s):  
Jaesik Park ◽  
Min A. Joo ◽  
Ho Joong Choi ◽  
Sang Hyun Hong ◽  
Chul Soo Park ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Propensity Score ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Fibrinogen Level ◽  
Kidney Injury ◽  
Emergency Operation ◽  
Donor Liver ◽  
Donor Liver Transplantation

Background This study investigated the association between the fibrinogen level and the risk of acute kidney injury (AKI) in patients who have undergone living donor liver transplantation (LDLT). Patients and methods A total of 676 patients who underwent LDLT were analyzed retrospectively. Exclusion criteria included a history of severe kidney dysfunction, emergency operation, deceased donor, ABO-incompatible transplantation, and missing data. The study population was divided into low and normal fibrinogen groups. A 1:1 propensity score (PS) matching analysis was used to evaluate the association between a low fibrinogen level (< 160 mg/dL) and postoperative development of AKI. Results In total, 142 patients (23.1%) developed AKI after LDLT. The PS matching analysis showed that the probability of AKI was two-fold higher in the low fibrinogen group than in the normal fibrinogen group. In addition, patients with AKI had poorer postoperative outcomes such as longer hospitalization, longer ICU stay, and higher mortality than patients without AKI. Conclusions The preoperative fibrinogen level may be useful for risk stratification of patients undergoing LDLT in terms postoperative development of AKI.

scholarly journals Predictive Role of the D-Dimer Level in Acute Kidney Injury in Living Donor Liver Transplantation: A Retrospective Observational Cohort Study

2022 ◽  
Vol 11 (2) ◽  
pp. 450
Author(s):  
Jaesik Park ◽  
Sung Un Kim ◽  
Ho Joong Choi ◽  
Sang Hyun Hong ◽  
Min Suk Chae
Keyword(s):  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Kidney Injury ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Final Study ◽  
History Of ◽  
D Dimer

This study aimed to determine the association between serum D-dimer levels and the risk of acute kidney injury (AKI) in patients undergoing living donor liver transplantation (LDLT). Clinical data of 675 patients undergoing LDLT were retrospectively analyzed. The exclusion criteria included a history of kidney dysfunction, emergency cases, and missing data. The final study population of 617 patients was divided into the normal and high D-dimer groups (cutoff: 0.5 mg/L). After LDLT, 145 patients (23.5%) developed AKI. A high D-dimer level (>0.5 mg/L) was an independent predictor of postoperative development of AKI in the multivariate analysis when combined with diabetes mellitus [DM], platelet count, and hourly urine output. AKI was significantly higher in the high D-dimer group than in the normal D-dimer group (odds ratio [OR], 2.792; 95% confidence interval [CI], 1.227–6.353). Patients with a high D-dimer exhibited a higher incidence of early allograft dysfunction, longer intensive care unit stay, and a higher mortality rate. These results could improve the risk stratification of postoperative AKI development by encouraging the determination of preoperative D-dimer levels in patients undergoing LDLT.

scholarly journals Association Between Red Blood Cell Distribution Width and Intraoperative Transfusion in Patients Undergoing Living Donor Liver Transplantation: a Retrospective Single-center Cohort Study

2021 ◽  
Author(s):  
Ji Hoon Sim ◽  
Hye-Mee Kwon ◽  
In-Gu Jun ◽  
Sung-Hoon Kim ◽  
Bomi Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Predictive Power ◽  
Kidney Injury ◽  
Cell Distribution ◽  
Donor Liver ◽  
Distribution Width ◽  
Donor Liver Transplantation

Abstract Background: Living donor liver transplantation (LDLT) has been associated with massive bleeding and increased blood transfusion requirements. However, information on indicators predicting bleeding and transfusion in LDLT is limited. Recent studies have reported a correlation between red cell distribution width (RDW) and bleeding risk. This study investigates the association between RDW and intraoperative blood transfusion in patients receiving LDLT.Methods: This retrospective study analyzed 2548 patients who underwent LDLT between January 2010 and October 2019. The patients were divided into four groups based on preoperative RDW quartiles: Q1 (<13.9), Q2 (13.9–15.2), Q3 (15.2–17.4), and Q4 (≥17.4), and transfusion requirement and surgical outcomes were assessed. The risk factors for intraoperative transfusion were evaluated by multivariate regression analysis. The predictive power of RDW was assessed through receiver operating characteristic (ROC) and integrated discrimination improvement (IDI) analysis.Results: There were significant differences in incidence of intraoperative transfusion according to preoperative RDW quartile (Q1 vs Q2 vs Q3 vs Q4: 47.3% vs. 78.1% vs. 91.8% vs. 96.2%, P<0.001). Q4 had poor surgical outcomes, such as acute kidney injury (adjusted odds ratio [OR]: 1.91, 95% CI: 1.44–2.54, P<0.001). In the multivariate logistic analysis, RDW, age, sex, diabetes mellitus, coronary artery disease, model for end-stage liver disease scores, and total ischemic time were risk factors for transfusion. In ROC and IDI analysis, RDW had predictive power for intraoperative transfusion (P=0.023 in IDI).Conclusions: Preoperative RDW is a potential predictor of intraoperative transfusion and postoperative acute kidney injury in patients receiving LDLT.

scholarly journals Predictive Role of Serum Cytokine Profiles in Acute Kidney Injury after Living Donor Liver Transplantation

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Min Suk Chae ◽  
Youngchan Kim ◽  
Hyun Sik Chung ◽  
Chul Soo Park ◽  
Jaemin Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Acute Kidney Injury ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Kidney Injury ◽  
Serum Cytokine ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Cytokine Profiles ◽  
Preoperative Serum

Introduction. Previous studies have shown that a higher serum interleukin- (IL-) 6 level is associated with a higher risk of acute kidney injury (AKI) development after major nontransplant surgery. Our study investigated the potential association of preoperative serum cytokine profiles with new AKI development in patients who underwent living donor liver transplantation (LDLT). Methods. Serum levels of cytokines IL-2, IL-6, IL-10, IL-12, and IL-17, interferon-γ, and tumor necrosis factor- (TNF-) α were measured in 226 LDLT recipients preoperatively and analyzed retrospectively. Recipients with a preoperative functional impairment of the kidney were excluded. AKI was defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results. In a univariate regression model, IL-6, IL-17, and TNF-α levels showed an association with AKI development after LDLT. Multivariate analysis showed an independent association of the preoperative serum IL-6 level with AKI development after LDLT and a significant relationship between higher serum IL-6 levels and a greater likelihood of developing AKI. Serum IL-6 levels were higher in patients with stage 3 AKI than in patients who did not develop AKI. Conclusions. Our results support the need for further investigations of IL-6 as a predictor of AKI development in patients undergoing LDLT.

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