Incidence and risk factors for early renal dysfunction after liver transplantation

doi:10.5500/wjt.v6.i1.220

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 6, Issue 1

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (6844)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Tables (1-3) series.

Item

Count

PDF

575

WORD

270

HTML

3322

Tables (1-3)

210

Sum=4377

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

894

Download

1573

Sum=2467

Mar 24, 2016 (publication date) through Nov 26, 2024

Times Cited of This Article

Times Cited (29)

Journal Information of This Article

Publication Name

World Journal of Transplantation

ISSN

2220-3230

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Transplant. Mar 24, 2016; 6(1): 220-232
Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.220

Table 1 Univariate analysis for severity of post orthotopic liver transplantation acute kidney injury

Variable	Whole group (n = 187)	Group 1 (n = 78)	Group 2 (n = 76)	Group 3 (n = 38)	Group 4 (n = 25)	P value between groups
Preoperative
Age (yr)	56 ± 10	54 ± 10	56 ± 10	58 ± 9	57 ± 12	0.055
Sex (male)	147 (79)	61 (78)	32 (70)	33 (87)	21 (84)	0.410
BMI (kg/m²)	26 ± 4.5	25 ± 4	26 ± 5	26 ± 5	26 ± 5.0	0.055
Hospital stay (d)	3 ± 8	2.2 ± 4.8	4.2 ± 12.9	2.7 ± 7.9	6.4 ± 9.6	0.150
Bilirubin (mg/L)	25 (12-66)	17.4 (8.7-44.8)	23.2 (13.1-60.6)	32.3 (15.8-64.9)	56.3 (23.1-115.0)	< 0.0001
Creatinine (mg/L)	9.5 (7.4-12.3)	7 (6.6-9.3)	10.4 (8.0-12.7)	11.5 (9.3-14.5)	13.4 (6.6-16.0)	< 0.0001
Urea (g/L)	0.47 ± 0.35	0.34 (0.20-0.42)	0.40 (0.30-0.59)	0.42 (0.33-0.68)	0.64 (0.38-0.92)	< 0.0001
Ascites	138 (73)	50 (64)	37 (80)	30 (79)	21 (84)	0.015
β blockers	67 (37)	24 (31)	18 (39)	17 (46)	8 (33)	0.400
ACEI	18 (10)	8 (11)	4 (9)	4 (11)	2 (8)	0.770
NSAIDs	5 (3)	1 (1)	2 (4)	1 (3)	1 (4)	0.480
Prior bacterial infection	62 (33)	16 (20)	18 (39.1)	13 (34.2)	15 (60)	0.0007
Intraoperative
DCD	63 (34)	25 (32)	17 (37)	12 (32)	9 (36)	0.790
Infection	50 (27)	17 (22)	12 (26)	13 (34)	8 (32)	0.140
Vasopressors	86 (46)	18 (23)	25 (54)	25 (66)	18 (72)	< 0.0001
Surgical revision	45 (24)	12 (15)	12 (26)	11 (29)	10 (40)	0.0087
Transfusion	169 (90)	66 (85)	44 (96)	37 (97)	22 (88)	0.060
Postoperative
Lactates D1 (mg/L)	434 ± 230	394 (270-509)	375 (279-484)	428 (283-527)	435 (334-711)	0.200
Minimum hemoglobin (g/dL)	8.0 (7.0-9.2)	8.9 (7.8-10.3)	7.7 (6.7-8.5)	7.55 (6.8-8.5)	6.7 (6.5-8.0)	< 0.0001
Bilirubin peak (mg/L)	40 (23-77.6)	37 (18-77)	32 (24-82)	51 (37-73)	60 (33-128)	0.006
ASAT (UI/L)	733 (372-1248)	554 (333-966)	804 (472-1988)	875 (399-1300)	822 (505-2458)	0.001
ALAT (UI/L)	617 (380-1068)	569 (332-941)	698 (399-1085)	546 (397-1113)	695 (407-1133)	0.260
Urea (g/L)	0.88 (0.6-1.3)	0.57 (0.46-0.69)	0.97 (0.80-1.14)	1.38 (1.21-1.64)	1.87 (1.52-2.18)	< 0.0001
Mechanical ventilation > 24 h	56 (30)	18 (23)	9 (20)	16 (42)	13 (52)	0.0026
Mechanical ventilation days	1 (1-2)	1 (1-1)	1 (1-1)	1 (1-2)	2 (1-2)	0.0014
RRT	20 (11)	4 (5)	2 (4)	1 (3)	13 (52)	< 0.0001
ICU stay (d)	3 (2-5)	2 (2-4)	3 (2-4)	5 (4-7)	6 (4-13)	0.0046
Tacrolimus	177 (95)	77 (99)	43 (94)	35 (92)	22 (92)	0.089
Cyclosporin	21 (11)	5 (6)	7 (15)	6 (16)	3 (13)	0.170
Additional immunosuppressant	185 (98)	77 (99)	46 (100)	38 (100)	24 (96)	0.550
Transfusion RCC D0 (U)	1 (0-3)	0 (0-2)	2 (0-4)	2 (1-5)	2 (1-5)	0.0007
Transfusion RCC D1 (U)	0 (0-1)	0 (0-0)	0 (0-1.5)	0 (0-2)	0 (0-4)	< 0.0001
Transfusion RCC D7 (U)	2 (0-5)	0 (0-3)	3 (1-6)	4 (2-7)	4 (2-12)	< 0.0001
Transfusion FFP D0 (U)	4 (2-6)	3 (0-6)	4 (2-7)	6 (3-9)	6 (3-8)	0.0031
Transfusion FFP D1 (U)	0 (0-2)	0 (0-0)	0 (0-2)	2 (0-3)	2 (0-4)	< 0.0001
Transfusion FFP D7 (U)	6 (2-10)	4 (1-6)	6 (2.5-10)	8 (4-11)	8 (6-15)	< 0.0001
Transfusion platelets D0 (CUP)	1 (0-1)	0 (0-1)	1 (0-1)	1 (0-1)	1 (1-2)	0.0008
Transfusion platelets D1 (CUP)	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-0)	0 (0-1)	0.0022
Transfusion platelets D7 (CUP)	1 (0-2)	0 (0-1)	1 (0-2.5)	1 (0-2)	2 (1-4)	< 0.0001

BMI: Body mass index; ACEI: Angiotensin-converting enzyme inhibitors; NSAIDs: Non-steroidal anti-inflammatory drugs; DCD: Donation after circulatory death; ASAT: Aspartate aminotransferase; ALAT: Alanine amino transferase; RRT: Renal replacement therapy; ICU: Intensive care unit.

Table 2 Multivariate analysis for increased post orthotopic liver transplantation serum creatinine level

	OR	95%CI	P value
BMI (kg/m²)	1.10	1.03-1.18	0.0044
Preoperative increased creatinine (ln - mg/L)	11.07	5.28-23.23	< 0.0001
Vasopressors use	3.31	1.75-6.29	0.0002
Postoperative minimum Hemoglobin (ln - g/dL)	0.06	0.01-0.29	0.0005
Postoperative bilirubin peak (ln - mg/L)	1.44	1.01-2.05	0.044

BMI: Body mass index; ln: Natural logarithm.

Table 3 Post hoc multivariate analysis highlighting the effect of anti-hemorragic treatment strategy on acute kidney injury occurrence

Risk not being into the 1^th group in multivariate analysis	OR	95%CI	P value
Antihemorragic treatment period	3.36	1.44-7.85	0.005
Preoperative increased creatinine (ln - mg/L)	1.36	1.20-1.54	< 0.0001
Bleeding (100 mL)	1.03	1.01-1.06	0.011

ln: Natural logarithm.

Citation: Wiesen P, Massion PB, Joris J, Detry O, Damas P. Incidence and risk factors for early renal dysfunction after liver transplantation. World J Transplant 2016; 6(1): 220-232
URL: https://www.wjgnet.com/2220-3230/full/v6/i1/220.htm
DOI: https://dx.doi.org/10.5500/wjt.v6.i1.220