Ayhan Asude, Ersoy Zeynep, Ulas Aydin, Zeyneloglu Pinar, Pirat Arash, Haberal Mehmet
Department of Anaesthesiology and Reanimation, Baskent University School of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2017 Feb;15(Suppl 1):258-260. doi: 10.6002/ect.mesot2016.P126.
Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes.
We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included.
A total of 177 (79 adult, 98 pediatric) orthotopic liver transplants were performed during the study period. Of these, 35 patients (19%) required renal replacement therapy during the early posttransplantation period. After excluding 5 patients with previous chronic renal failure, 30 patients (17%; 20 adult [25% ], 10 pediatric [10% ]) with acute kidney injury required renal replacement therapy. The mean patient age was 31.1 ± 20.0 years, with a mean Model for End-stage Liver Disease score of 16.7 ± 12.3. Of the patients with acute kidney injury who underwent renal replacement therapy, in-hospital mortality was 23.3% (7 of 30 patients), and 40% remained on dialysis. No significant difference was seen in mortality between early versus delayed initiation of renal replacement therapy in patients with stage 3 acute kidney injury (P = .17).
Of liver transplant recipients who present with acute kidney injury, 19% require renal replacement therapy, and in-hospital mortality is 20% in the early postoperative period.
我们的目的是评估原位肝移植后肾脏替代治疗的发生率，并评估和分析患者的预后情况。
我们对一家三级医疗机构中2010年1月至2016年6月期间连续进行原位肝移植的177例患者进行了回顾性分析。纳入原位肝移植后入住重症监护病房且需要肾脏替代治疗的患者。
在研究期间共进行了177例（79例成人，98例儿童）原位肝移植。其中，35例患者（19%）在移植后早期需要肾脏替代治疗。排除5例既往有慢性肾衰竭的患者后，30例（17%；20例成人[25%]，10例儿童[10%]）急性肾损伤患者需要肾脏替代治疗。患者的平均年龄为31.1±20.0岁，终末期肝病模型平均评分为16.7±12.3。在接受肾脏替代治疗的急性肾损伤患者中，住院死亡率为23.3%（30例患者中有7例），40%的患者仍需透析。3期急性肾损伤患者早期与延迟开始肾脏替代治疗的死亡率无显著差异（P = 0.17）。
出现急性肾损伤的肝移植受者中，19%需要肾脏替代治疗，术后早期住院死亡率为20%。
