Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
Division of Medical Education, Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
J Chin Med Assoc. 2024 Jun 1;87(6):635-642. doi: 10.1097/JCMA.0000000000001103. Epub 2024 May 1.
Liver transplantation is treatment option for patients with end-stage liver disease and hepatocellular carcinoma. Renal function deterioration significantly impacts the survival rates of liver recipients, and serum uric acid (SUA) is associated with both acute and chronic renal function disorders. Thus, our study aimed to assess the relationship and predictive value of preoperative SUA level and postoperative acute kidney injury (AKI) in living donor liver transplantation (LDLT).
We conducted a prospective observational study on 87 patients undergoing LDLT. Blood samples were collected immediately before LDLT, and renal function status was followed up for 3 consecutive days postoperatively.
Low SUA levels (cutoff value 4.15 mg/dL) were associated with a high risk of early posttransplantation AKI. The area under the curve was 0.73 (sensitivity, 79.2%; specificity, 59.4%). Although not statistically significant, there were no deaths in the non-AKI group but two in the early AKI group secondary to liver graft dysfunction in addition to early AKI within the first month after LDLT.
AKI after liver transplantation may lead to a deterioration of patient status and increased mortality rates. We determined low preoperative SUA levels as a possible risk factor for early postoperative AKI.
肝移植是治疗终末期肝病和肝细胞癌患者的一种选择。肾功能恶化显著影响肝移植受者的生存率,而血清尿酸(SUA)与急性和慢性肾功能障碍均有关。因此,我们的研究旨在评估活体肝移植(LDLT)术前 SUA 水平与术后急性肾损伤(AKI)的关系及其预测价值。
我们对 87 例行 LDLT 的患者进行了前瞻性观察性研究。在 LDLT 前采集血样,并在术后连续 3 天随访肾功能状态。
低 SUA 水平(临界值 4.15mg/dL)与早期移植后 AKI 的高风险相关。曲线下面积为 0.73(灵敏度为 79.2%,特异性为 59.4%)。尽管无统计学意义,但在非 AKI 组中没有死亡病例,但在早期 AKI 组中,除了 LDLT 后第一个月内的早期 AKI 外,还有两例因肝移植物功能障碍导致的死亡。
肝移植后 AKI 可能导致患者病情恶化和死亡率增加。我们确定低术前 SUA 水平是术后早期 AKI 的一个可能危险因素。