Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases.

J Transplant 2018 23;2018:5910372. Epub 2018 Dec 23.

Liver Transplantation Unit and Gastroenterology Center, Faculty of Medicine, University of Mansoura, Mansoura, Egypt.

The possible risk factors for chronic kidney disease in transplant recipients have not been thoroughly investigated after living-donor liver transplantation. A retrospective cohort study of consecutive adults who underwent living-donor liver transplantation between May 2004 and October 2016, in a single center, was conducted. Kidney function was investigated successively for all the patients throughout the study period, with 12 months being the shortest follow-up. Postoperative renal dysfunction was defined in accordance with the Chronic Kidney Disease Epidemiology Collaboration criteria. The patients' demographic data, preoperative and intraoperative parameters, and outcomes were recorded. A calcineurin inhibitor-based immunosuppressive regimen, either tacrolimus or cyclosporine, was used in all the patients. Of the 413 patients included in the study, 33 (8%) who survived for ≥1 year experienced chronic kidney disease 1 year after living-donor liver transplantation. Twenty-seven variables were studied to compare between the patients with normal kidney functions and those who developed chronic kidney disease 1 year after living-donor liver transplantation. Univariate regression analysis for predicting the likelihood of chronic kidney disease at 1 year revealed that the following 4 variables were significant: operative time, < 0.0005; intraoperative blood loss, < 0.0005; preoperative renal impairment, = 0.001; and graft-to-recipient weight ratio (as a negative predictor), < 0.0005. In the multivariate regression analysis, only 2 variables remained as independent predictors of chronic kidney disease at 1 year, namely, operative time with a cutoff value of ≥714 minutes and graft-to-recipient weight ratio as a negative predictor with a cutoff value of <0.91. In this study, prolonged operative time and small graft-to-recipient weight ratio were independent predictors of chronic kidney disease at 1 year after living-donor liver transplantation.

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http://dx.doi.org/10.1155/2018/5910372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323484PMC
December 2018

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