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Perioperative risk factors of acute kidney injury post liver transplantation: a monocentric retrospective cohort study of 260 patients
Malisoux, Clarisse; KOCH, Jean-Noël; MEURISSE, Nicolas et al.
2021In Transplant International, 34 (S1 POS315), p. 312
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Abstract :
[en] Aims and Background: Acute kidney injury (AKI) is a major risk factor of poor outcomes after liver transplantation (LT). AKI is usually attributed to post-LT events and drug toxicity. Peri-operative risk factors of LT-associated AKI remain poorly documented, which hampers the development of personalized preventive strategies. Methods: AKI was assessed by KDIGO criteria based on creatinine changes from baseline to day 5 post LT. 260 single first full-size LTs without any pre-existing renal replacement therapy (RRT) were performed from 2003 to 2018. Incidence of AKI was assessed. Logistic regression determined the risk factors of KDIGO I and II-III AKI. Results: Incidence of AKI KDIGO I and II-III was 30% (78/260) and 25.7% (67/260), respectively. Preoperatively, patients with AKI had higher lab- MELD and Child-Pugh scores, lower serum fibrinogen and albumin levels. Donor type, donor hepatectomy and cold ischemic time were similar between groups. AKI was more frequent in case of marginal donors. LT surgery was longer in the AKI groups. Needs for per-operative blood transfusions were higher in the AKI groups. Rate of post-reperfusion syndrome was higher in AKI groups. Postoperatively, lower hemoglobin levels and higher INR from day 1-5 were associated with AKI. Peak of transaminases were not different between AKI versus non-AKI groups. AKI was associated with longer length of hospital and ICU stays. After multivariate analysis, blood transfusions and post-reperfusion syndrome were risk factors to develop KDIGO I AKI. Pre-operative serum levels of fibrinogen and albumin were risk factors for KDIGO II-III AKI. Finally, “marginal donors” was the only risk factor for both KDIGO I and II-III AKI. Conclusions: LT-associated AKI occurs in >50% of cases. Per-operative hemorrhage and post-operative reperfusion syndrome represent risk factors, particularly in cases of marginal donors.
Disciplines :
Gastroenterology & hepatology
Surgery
Author, co-author :
Malisoux, Clarisse ;  Centre Hospitalier Universitaire de Liège - CHU > Département infirmier > Infirmiers perfusionnistes
KOCH, Jean-Noël ;  Centre Hospitalier Universitaire de Liège - CHU > Département infirmier > Infirmiers perfusionnistes
MEURISSE, Nicolas ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Lagny, Marc ;  Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
VANDERMEULEN, Morgan ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
HONORE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
JOURET, François  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de néphrologie
DELANAYE, Pierre  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de néphrologie
DETRY, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
Language :
English
Title :
Perioperative risk factors of acute kidney injury post liver transplantation: a monocentric retrospective cohort study of 260 patients
Publication date :
August 2021
Event name :
ESOT 2021
Event organizer :
European Society of Transplantation
Event place :
Milan, Italy
Event date :
Du 29 aout au 1 septembre 2021
Audience :
International
Journal title :
Transplant International
ISSN :
0934-0874
eISSN :
1432-2277
Publisher :
Blackwell, Oxford, United Kingdom
Volume :
34
Issue :
S1 POS315
Pages :
312
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 12 September 2021

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