The Predictors for Continuous Renal Replacement Therapy in Liver Transplant Recipients

Kim, J.M.; Jo, Youn Yi; Na, Sungwon; Kim, S.I.; Choi, Yong Seon; Kim, N.O.; Park, J.E.; Koh, Shin Ok

doi:10.1016/j.transproceed.2013.07.075

Cited by 29 publications

(55 citation statements)

References 34 publications

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“…While it may be useful to evaluate the risk factors for AKI after OLT, this is not the focus of our study, and this topic has recently been evaluated and published elsewhere. 7,8,13 In conclusion, the present study demonstrated that 19% of liver-graft recipients who present with AKI (30.5% of all OLT patients) require RRT. The inhospital mortality for these patients was 20% in the early postoperative period, and there was no statistically significant difference between early and delayed RRT in patients with AKI.…”

Section: Discussionsupporting

confidence: 51%

Untitled

Ayhan

Ersoy²,

Ulas³

et al. 2017

Exp Clin Transplant

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Section: Discussionsupporting

confidence: 51%

Untitled

Ayhan

Ersoy²,

Ulas³

et al. 2017

Exp Clin Transplant

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“…The amount of transfused red blood cell (RBC) concentrates is both also related to the disease severity of the recipient and represents the complexity of the transplantation surgery being a surrogate marker for intraoperative bleeding and intermittent hypotension. Both features were previously shown to induce AKI after major surgeries and transplantation …”

Section: Discussionmentioning

confidence: 84%

Piggyback or Cava Replacement: Which Implantation Technique Protects Liver Recipients From Acute Kidney Injury and Complications?

et al. 2018

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The cava-preserving piggyback (PB) technique requires only partial cava clamping during the anhepatic phase in liver transplantation (LT) and, therefore, maintains venous return and may hemodynamically stabilize the recipient. Hence, it is an ongoing debate whether PB implantation is more protective from acute kidney injury (AKI) after LT when compared with a classic cava replacement (CR) technique. The aim of this study was to assess the rate of AKI and other complications after LT comparing both transplant techniques without the use of venovenous bypass. We retrospectively analyzed the adult donation after brain death LT cohort between 2008 and 2016 at our center. Liver and kidney function and general outcomes including complications were assessed. Overall 378 transplantations were analyzed, of which 177 (46.8%) were performed as PB and 201 (53.2%) as CR technique. AKI occurred equally often in both groups. Transient renal replacement therapy was required in 22.6% and 22.4% comparing the PB and CR techniques (P = 0.81). Further outcome parameters including the complication rate were similar in both cohorts. Five-year graft and patient survival were comparable between the groups with 81% and 85%, respectively (P = 0.48; P = 0.58). In conclusion, both liver implantation techniques are equal in terms of kidney function and overall complications following LT.

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“…The database search yielded an initial result of 624 references. Six studies described the primary development of a prediction model 12,[29][30][31][32][33] and one article developed a risk score for predicting AKI following liver transplantation 25 . There were no studies reporting external validation of pre-existing models.…”

Section: Resultsmentioning

confidence: 99%

“…Research into post LT kidney injury has experienced a transformation, with evolving definitions for AKI as well as the emergence of new methods for determining renal function. It is an expanding field, with recent studies continuing to identify new independent risk factors 28 as well as the recent publication of new predictive models 29,30 .…”

mentioning

confidence: 99%

Acute Kidney Injury following Liver Transplantation: A Systematic Review of Published Predictive Models

Caragata

Wyssusek

Krüger

2016

Anaesth Intensive Care

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Acute kidney injury (AKI) is a frequent postoperative complication amongst liver transplant recipients and is associated with increased morbidity and mortality. This systematic review analysed the existing predictive models, in order to solidify current understanding. Articles were selected for inclusion if they described the primary development of a clinical prediction model (either an algorithm or risk score) to predict AKI post liver transplantation. The database search yielded a total of seven studies describing the primary development of a prediction model or risk score for the development of AKI following liver transplantation. The models span thirteen years of clinical research and highlight a gradual change in the definitions of AKI, emphasising the need to employ standardised definitions for subsequent studies. Collectively, the models identify a diverse range of predictive factors with several common trends. They emphasise the impact of preoperative renal dysfunction, liver disease severity and aetiology, metabolic risk factors as well as intraoperative variables including measures of haemodynamic instability and graft quality. Although several of the models address postoperative parameters, their utility in predictive modelling seems to be of questionable relevance. The common risk factors identified within this systematic review provide a minimum list of variables, which future studies should address. Research in this area would benefit from prospective, multisite studies with larger cohorts as well as the subsequent internal and external validation of predictive models. Ultimately, the ability to identify patients at high risk of post-transplant AKI may enable early intervention and perhaps prevention.

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The Predictors for Continuous Renal Replacement Therapy in Liver Transplant Recipients

Cited by 29 publications

References 34 publications

Untitled

Untitled

Piggyback or Cava Replacement: Which Implantation Technique Protects Liver Recipients From Acute Kidney Injury and Complications?

Acute Kidney Injury following Liver Transplantation: A Systematic Review of Published Predictive Models

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