Kim Jae Hwan, Kim Kyoung-Sun, Kwon Hye-Mee, Kim Sung-Hoon, Jun In-Gu, Song Jun-Gol, Hwang Gyu-Sam
From the Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea.
Depatment of Anesthesiology and Painmedicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Anesth Analg. 2024 Oct 16. doi: 10.1213/ANE.0000000000007253.
Acute kidney injury (AKI) is one of the most common complications after liver transplantation (LT) and can significantly impact outcomes. The presence of hepatitis C virus (HCV) infection increases the risk of AKI development. However, the impact of HCV on AKI after LT has not been evaluated. The aim of this study was to assess the effect of HCV on AKI development in patients who underwent LT.
Between January 2008 and April 2023, 2183 patients who underwent living donor LT (LDLT) were included. Patients were divided into 2 groups based on the presence of chronic HCV infection. We compared LT recipients using the propensity score matching (PSM) method. Factors associated with AKI development were evaluated using multiple logistic regression analysis. In addition, 1-year mortality and graft failure were assessed using a Cox proportional regression model.
Among 2183 patients, the incidence of AKI was 59.2%. After PSM, the patients with HCV showed a more frequent development of AKI (71.9% vs 63.9%, P = .026). In multivariate analysis after PSM, HCV was associated with AKI development (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.06-2.20, P = .022), 1-year mortality (Hazard ratio [HR], 1.98; 95% CI, 1.12-3.52, P = .019), and graft failure (HR, 2.12; 95% CI, 1.22-3.69, P = .008).
The presence of HCV was associated with increased risk for the development of AKI, 1-year mortality, and graft failure after LT.
急性肾损伤（AKI）是肝移植（LT）后最常见的并发症之一，会显著影响预后。丙型肝炎病毒（HCV）感染会增加AKI发生的风险。然而，HCV对LT后AKI的影响尚未得到评估。本研究的目的是评估HCV对接受LT患者发生AKI的影响。
纳入2008年1月至2023年4月期间接受活体肝移植（LDLT）的2183例患者。根据是否存在慢性HCV感染将患者分为两组。我们使用倾向评分匹配（PSM）方法比较肝移植受者。使用多因素逻辑回归分析评估与AKI发生相关的因素。此外，使用Cox比例回归模型评估1年死亡率和移植失败情况。
在2183例患者中，AKI的发生率为59.2%。PSM后，HCV患者发生AKI的频率更高（71.9%对63.9%，P = 0.026）。PSM后的多因素分析中，HCV与AKI发生相关（比值比[OR]，1.53；95%置信区间[CI]，1.06 - 2.20，P = 0.022）、1年死亡率（风险比[HR]，1.98；95%CI，1.12 - 3.52，P = 0.019）和移植失败（HR，2.12；95%CI，1.22 - 3.69，P = 0.008）。
HCV的存在与LT后发生AKI、1年死亡率和移植失败的风险增加相关。
