Does the development of chronic kidney disease and acute kidney injury affect the prognosis after living donor liver transplantation?. Issue 5 (14th March 2016)

• Record Type: Journal Article
• Authors: Inoue, Yusuke; Soyama, Akihiko; Takatsuki, Mitsuhisa; Hidaka, Masaaki; Kinoshita, Ayaka; Natsuda, Koji; Baimakhanov, Zhassulan; Kugiyama, Tota; Adachi, Tomohiko; Kitasato, Amane; Kuroki, Tamotsu; Eguchi, Susumu
• Is Part Of: Clinical transplantation. Volume 30:Issue 5(2016)
• Page Start: 518
• Page End: 527
• Publication Date: 2016-03-14
• Subjects: age -- acute kidney injury -- chronic kidney disease -- diabetes -- HCV -- intra‐operative bleeding -- sepsis; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12715
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background and aims: Chronic kidney disease (CKD) and acute kidney injury (AKI) have been discussed as complications following living donor liver transplantation (LDLT). The aim of this study was to clarify the relationships among CKD, AKI, and the prognosis after LDLT. Methods: This study included 118 patients who underwent LDLT in our department. A low eGFR (<60 mL/min/1.73 m 2 ) was regarded to indicate CKD. AKI 1 and AKI 2 were characterized by an increase in the serum creatinine level of 0.5 and 1.0 mg/dL, respectively, within one wk after LDLT. We investigated the risk factors for and the relevance of CKD and AKI on the prognosis. Results: AKI 1 was associated with sepsis and intra‐operative bleeding (p = 0.0032, p = 0.001). AKI 2 was associated with sepsis and hepatitis C infection (p < 0.001, p = 0.027). A pre‐operative eGFR of 60–89 and diabetes were the risk factors for the development of CKD in POY 2 (p = 0.018, p = 0.002). AKI 2, sepsis, and diabetes were the risk factors for the patient death within one yr after LDLT (p = 0.010, p = 0.002, p = 0.022). AKI 2 and sepsis were the risk factors for death within two yr after LDLT (p = 0.005, p = 0.018). Conclusions: Recognizing the risk factors and careful management for preventing both AKI and CKD may improve the prognosis of patients following LDLT.