Evaluation of perioperative predictors of acute kidney injury post orthotopic liver transplantation

被引:14
|
作者
Wyssusek, K. H. [1 ,2 ]
Keys, A. L. B. [1 ]
Yung, J. [1 ]
Moloney, E. T. [3 ]
Sivalingam, P. [4 ]
Paul, S. K. [5 ]
机构
[1] Princess Alexandra Hosp, Dept Anaesthesia, Brisbane, Qld 4102, Australia
[2] Univ Queensland, Sch Med, Brisbane, Qld, Australia
[3] Alfred Hosp, Melbourne, Vic, Australia
[4] Princess Alexandra Hosp, Dept Anaesthesia, Res, Brisbane, Qld 4102, Australia
[5] QIMR Berghofer Med Res Inst, Clin Trials & Biostat Unit, Brisbane, Qld, Australia
关键词
acute kidney injury; liver transplantation; mortality; body mass index; ACUTE-RENAL-FAILURE; RISK-FACTORS; REPLACEMENT THERAPY; PATIENT; MODEL;
D O I
10.1177/0310057X1504300614
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Acute kidney injury (AKI) is a common complication following orthotopic liver transplantation. It is associated with increased morbidity and mortality, as well as increased healthcare costs. The aetiology of AKI post liver transplantation is multifactorial and understanding these factors is pivotal in developing risk stratification and prevention strategies. This study aims to investigate the preoperative and intraoperative factors that may be associated with AKI in patients undergoing liver transplantation at the Princess Alexandra Hospital, Brisbane, Queensland. In our study, retrospective data of 97 consecutive orthotopic liver transplantations performed between January 2009 and August 2012 were recorded. Univariate and multivariate analyses were performed to investigate the preoperative and intraoperative risk factors for the development of AKI in this cohort. In the cohort of 97 patients who underwent orthotopic liver transplantation, 24 patients (25%) developed postoperative AKI. Univariate analysis demonstrated that high preoperative body mass index and intraoperative noradrenaline use were both associated with AKI. Multivariate analysis demonstrated that high body mass index, high Model for End-stage Liver Disease score and intraoperative noradrenaline use were associated with AKI. Overall mortaility was 4.1% during the study period and was not significantly different between the two groups. The high incidence of AKI following liver transplantation in this study cohort highlights the importance of this issue. This study has identified several potential pre- and intraoperative risk factors, providing a focus for patient surveillance and future research.
引用
收藏
页码:757 / 763
页数:7
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