engleski

Intraoperative factors associated with acute kidney injury after a liver transplantation- single centre experience

Background and Goal of Study: Acute kidney injury (AKI) after liver transplantation (LT) can increase mortality and foster the development of chronic renal dysfunction. In this study, we analysed intraoperative factors associated with AKI in patients who underwent LT. Materials and Methods: This retrospective study consisted of 191 adult patients who underwent LT during two consecutive years. AKI was determined using KDIGO classification (Kidney Disease Improving Global Outcomes) as an increase in serum creatinine by 26.5 µmol/l within 48 hours or an increase in serum creatinine to 1.5 times baseline after LT. We analysed volume resuscitation (ml) with a red blood cells transfusion (homologous or/and autologous blood) ; fresh frozen plasma ; crystalloids, colloids, albumins and noradrenaline dosage (mcg/min) during LT. Student t-test was used for analysis. Results and Discussion: The patients were comparable in terms of age, BMI, etiology of liver cirrhosis and comorbidities (diabetes mellitus, chronic kidney disease, arterial hypertension). The incidence of AKI was 24, 6%. MELD-Na was significantly higher in patients with AKI (21.7 ± 8.1 vs 17.2 ±7.1 ; p < 0.001) as well as preoperative serum creatinine (116.5±95.4 vs. 84.3±51.45 µmol/l ; p < 0.003). Patients with AKI received significantly more intraoperative red blood cells via transfusion (2578±1685 vs. 2076±1441 ml ; p= 0.0484) in comparison with non AKI patients, as well as noradrenaline dosage used during LT (11±13 vs. 7.5±9 mcg/min ; p=0.0491). Among all other analysed factors, we found no significant differences. Conclusion: In this study we have shown that almost one quarter of patients developed AKI after a LT. Patients with AKI received more red blood cells via transfusion and higher doses of noradrenaline during LT. The aforementioned is consistent with the knowledge that higher doses of noradrenaline cause vasoconstriction of renal vasculature leading to renal failure.

Liver transplantation ; AKI

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