Liver transplantationComplication: RenalRIFLE Criteria and Hepatic Function in the Assessment of Acute Renal Failure in Liver Transplantation
Section snippets
Selection and Description of Participants
We prospectively collected the records of 24 patients who underwent deceased donor OLT from August 2008 to October 2009. Exclusion criteria were acute hepatic failure and retransplantation. Clinical data included in the study were: recipient age and gender, MELD score, hepatic failure etiology of HCV or hepatitis B virus (HBV) infection, hepatocarcinoma, large-volume ascites, spontaneous bacterial peritonitis, hepatorenal syndrome (HRS), diabetes mellitus, hypertension, pre-OLT renal failure
Results
On the basis of the RIFLE criteria, ARF occurred in 9/24 patients (37.5%); including 5 (56%) who developed the R grade and 4 (44%), the I grade; no patient developed the F grade. Of the 6 patients with CKD pretransplant, 1 developed ARF (16.7%; 95% CI, 3.0–56.4); 5 did not (83.3%; 95% CI 43.6–97.0). Of the 18 patients with normal renal function before transplantation, 8 developed ARF (44.4%; 95% CI, 24.6–66.3); 10 did not (55.6%; 95% CI, 33.7–75.4). The R grade developed more frequently among
Discussion
Herein we have described the incidence of ARF among 24 liver transplant patients in relationship to pre-OLT hepatic and renal functions as well as its influence on post-OLT CKD.
According to the RIFLE criteria, the incidence of ARF in our study was 37.5% with 56% showing a risk of renal dysfunction and 44% injury to the kidney, findings which agree with the literature. Interestingly, we observed an association of ARF with MELD score and hypoalbiminemia, but not with pre-OLT renal function as
References (15)
- et al.
Pretransplant renal function predicts survival in patients undergoing orthotopic liver transplantation
Hepatology
(2002) - et al.
Continued influence of preoperative renal function on outcome of orthotopic liver transplant in the US: where will MELD lead us?
Am J Transplant
(2006) - et al.
A model to predict survival in patients with end-stage liver disease
Hepatology
(2001) - et al.
Risk of acute renal failure after liver transplantation
Kidney Int
(2006) - et al.
Characteristics associated with liver graft failure: the concept of a donor risk index
Am J Transplant
(2006) - et al.
Defining and classifying acute renal failure: from advocacy to consensus and validation of the RIFLE criteria
Intens Care Med
(2007) - et al.
Prediction of GFR in liver transplant candidates
Am J Kidney Dis
(2003)
Cited by (36)
Kidney failure after liver transplantation
2022, Nephrologie et TherapeutiqueRisk factors and associated outcomes of early acute kidney injury in pediatric liver transplant recipients: A retrospective study
2020, Journal of Pediatric SurgeryCitation Excerpt :Therefore, more studies are required to investigate the correlation between AKI and short-term or long-term outcomes in pediatric liver recipients. Previous studies [28,29,30] found patients who were diagnosed with AKI after liver transplantation universally had a higher percentage of RRT. Although RRT has been an effective therapy for severe AKI cases after liver transplantation [24], Papadopoulos et al. [31] found that adult patients who required postoperative RRT after liver transplantation had a higher associated mortality rate.
Critical Care Management of Living Donor Liver Transplants
2019, Critical Care ClinicsAcute kidney injury after liver transplantation: Recent insights and future perspectives
2017, Best Practice and Research: Clinical GastroenterologyCitation Excerpt :Furthermore, a more advanced stage of liver disease before liver transplantation increases the risk of post-LT complications, including AKI [60]. Several studies have shown an association between pre-LT MELD score and post-LT AKI [3,15,61]. Especially patients with high MELD-scores are found to have a significantly increased risk of post-LT AKI.
Relationship Between Intraoperative Hypotension and Acute Kidney Injury After Living Donor Liver Transplantation: A Retrospective Analysis
2017, Journal of Cardiothoracic and Vascular AnesthesiaAcute Renal Injury Evaluation after Liver Transplantation: With RIFLE Criteria
2015, Transplantation ProceedingsCitation Excerpt :In our study, patients with MELD score ≥20 had 3.862 times more risk for ARI for the 7th day of the surgery. Tinti et al [29] found this for the result of hepatic and renal function relation in cirrhotic patients. Finally, we acknowledge the potential limitations of this study.