Liver Transplantation and Research Center, 302 Hospital, Beijing, China.
Research and Technology Service Center, 302 Hospital, Beijing, China.
Turk J Gastroenterol. 2021 Jan;32(1):82-87. doi: 10.5152/tjg.2020.19592.
BACKGROUND/AIMS: To explore risk factors of acute kidney injury (AKI) and its severity after liver transplantation.
This was a retrospective cohort of consecutive adults undergoing orthotopic liver transplantation (OLT) at a referral hospital. Risk factors for AKI from 1week post-liver transplantation and 4-week outcomes were analysed. Further analyses of factors that influenced the severity of AKI were also performed.
A total of 204 patients were included. AKI was found in 55.4% of patients in the first week after OLT. Risk factors for AKI were recipient's sex, BMI, preoperative creatinine, preoperative hepatic encephalopathy, cold ischaemia time, duration of surgery, duration of inferior vena clamping, postoperative peak lactate and postoperative peak AST, which were higher in the AKI group. Four weeks after liver transplantation, 20.4% of AKI patients still had abnormal renal function and a mortality rate of 3.6%, and these values were significantly higher than those of patients without AKI (P<0.05).
Preoperative, intraoperative and postoperative factors can all lead to AKI after OLT.
背景/目的：探讨肝移植术后急性肾损伤（AKI）及其严重程度的危险因素。
这是一项回顾性队列研究，纳入了在一家转诊医院接受原位肝移植（OLT）的连续成年患者。分析了肝移植后 1 周和 4 周的 AKI 风险因素以及影响 AKI 严重程度的因素。
共纳入 204 例患者。OLT 后第 1 周，55.4%的患者发生 AKI。AKI 的危险因素包括患者性别、BMI、术前肌酐、术前肝性脑病、冷缺血时间、手术时间、下腔静脉阻断时间、术后峰值乳酸和术后峰值 AST，这些因素在 AKI 组中更高。肝移植后 4 周，20.4%的 AKI 患者仍存在肾功能异常，死亡率为 3.6%，这些值明显高于无 AKI 患者（P<0.05）。
肝移植术后 AKI 可由术前、术中和术后的多种因素引起。
