Acute Kidney Injury After Liver Transplantation: Incidence, Risk Factors, and Outcomes

Authors : Zeynep ERSOY, Nedim ÇEKMEN, Aycan ÖZDEMİRKAN, Pınar ZEYNELOGLU, Adnan TORGAY, Mehmet HABERAL

Pages : 1-11

Doi:10.36516/jocass.1225060

View : 24 | Download : 7

Publication Date : 2023-04-30

Article Type : Research Paper

Abstract :Introduction: Although numerous risk factors for acute kidney injury insert ignore into journalissuearticles values(AKI); have been identified, their cumulative impact remains unclear. This study aimed to identify perioperative risk factors for early post-transplant AKI on patients and outcomes and to predict AKI using clinical variables. Material and Methods: A single-center, retrospective cohort study involving 34 pediatric patients and 31 adults who underwent LT between 2015 and 2017. Results: AKI occurred in 16 insert ignore into journalissuearticles values(47%); pediatric patients during the first-week post-LT with stage 1, stage 2, and stage 3 AKI frequencies of 43.8, 50, and 6.3%, respectively. Renal replacement therapy insert ignore into journalissuearticles values(RRT); was initiated in 18.8% of pediatric LT patients. Preoperative liver enzymes and the etiology of liver failure are the most critical factors affecting AKI in pediatric LT patients. AKI occurred in 15 insert ignore into journalissuearticles values(48%); adult patients during the first-week post-LT with stage 1, stage 2, and stage 3 AKI frequencies of 43%, 21%, and 21%, respectively. The requirement for RRT was seen in 43% of adult LT patients. There were also statistical differences between the two groups regarding the number of patients with preoperative kidney dysfunction insert ignore into journalissuearticles values(20-80%, p=.047); and mortality rates insert ignore into journalissuearticles values(6-31 %, p=.047);. In adult patients who developed post-LT AKI compared with those who did not develop post-LT AKI, they had significantly higher levels of serum creatinine insert ignore into journalissuearticles values(sCr); insert ignore into journalissuearticles values(1.9±1.9 mg/dL vs. 0.7±0.1 mg/dL, p=.013);, were given lower amounts of crystalloids insert ignore into journalissuearticles values(73±32 mL/kg vs. 106±33 mL/kg, p=.018); and had lower urine output insert ignore into journalissuearticles values(UO); intraoperatively insert ignore into journalissuearticles values(11±9 mL/kg vs. 20±9 mL/kg, p=.047);. There was a higher mortality rate in adult patients with post-LT AKI insert ignore into journalissuearticles values(89 vs. 11%, p=.003);. Conclusion: The results of our study contribute to raising awareness of the potential risk factors associated with preoperative evaluation, intraoperative and postoperative close follow-up, careful anesthesia management, and early onset of post-LT AKI.
Keywords : Karaciğer transplantasyonu, akut böbrek hasarı, perioperatif yönetim, risk faktörleri, sonuçlar

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