The Risk Factors And Diagnosis For Early Acute Kidney Injury After Liver Transplantation

Objective:Identification of risk factors of acute kidney injury(AKI) after liver transplantation(LT) may avoid the development and attenuate the impact on patient outcome. Therefore, the incidence and risk factors of AKI after LT at Jiangxi Province People’s Hospital were analyzed.Methods:The research topic was reviewed by Jiangxi Province People’s Hospital OL Ethics Committee.The study was retrospectively analyzed from the LT patients at the Jiangxi Province People’s Hospital between April 2005 and April 2014. AKI was defined as an increased in serum creatinine level more than 1.5 times within the first week postoperation compared with the preoperative level. AKI and Non-AKI parients’ clinical data were analyzed.Results:(1) A total of 115 liver transplant patients were analyzed. The mean age was 45.3years(range, 23 to 68) and there were 20 women(30.86%) and 95 men(69.14%). Fifty-six patients(48.69%) developed AKI.(2) The univariate analysis identified preoperative MELD score, preoperative renal dysfunction, prolonged intraoperative hypotension, intraoperative anhepatic time, intraoperative blood loss, intraoperative blood transfusion, postoperative hypotension and postoperative blood transfusion as the risk factors of AKI(P<0.05).(3) By the multivarate Logistic Regression analysis, preoperative renal dysfunction, prolonged intraoperative hypotension more than 30 minutes and presence of postoperative hypotension were the independent risk factors of AKI(P<0.05).(4) The 1-month and 1-year cumulative survival rates were 87.5% and 78.57% in AKI group, 100% and 96.61% in non-AKI group. The 1-year overall cumulative survival rate was 87.8%.Conclusions : AKI was a common complication after LT, which caused increased morbidity and mortality. Although some patients required dialysis, most of them recovered normal renal function. Preoperative renal dysfunction, prolonged intraoperative hypotension and presence of postoperative hypotension were the independent risk factors of AKI after LT.