Early Persistent Progressive Acute Kidney Injury and Graft Failure Post Liver Transplantation.
Journal
Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
27
12
2018
revised:
17
12
2018
accepted:
12
01
2019
entrez:
19
3
2019
pubmed:
19
3
2019
medline:
19
3
2019
Statut:
epublish
Résumé
Acute kidney injury (AKI) in the setting of liver transplantation is a common and multifaceted complication. Studies in the general population have demonstrated worse prognosis with AKI episodes that persist for a longer duration. Our primary objective was to evaluate the impact of early AKI episodes that are persistent or progressive in nature, on patient outcomes and graft survival. This was a retrospective cohort study including all patients who received a liver transplant between 2011 and 2015 at our center. Moderate to severe AKI episodes (AKIN II or III) were recorded immediately before transplantation and after surgery until hospital discharge. We evaluated the incidence density rate (IDR) of graft failure and the time to graft failure in patients with persistent or progressive AKI ( Two hundred seventy-nine patients received 301 deceased donor liver allografts. Progressive or persistent AKI was documented in more than half of transplant cases (152/301). The rate of graft loss was 3 times higher in the Persistent or progressive AKI after liver transplantation is associated with an increased incidence rate of graft failure and is an independent predictor of decreased graft survival time.
Sections du résumé
BACKGROUND
BACKGROUND
Acute kidney injury (AKI) in the setting of liver transplantation is a common and multifaceted complication. Studies in the general population have demonstrated worse prognosis with AKI episodes that persist for a longer duration. Our primary objective was to evaluate the impact of early AKI episodes that are persistent or progressive in nature, on patient outcomes and graft survival.
METHODS
METHODS
This was a retrospective cohort study including all patients who received a liver transplant between 2011 and 2015 at our center. Moderate to severe AKI episodes (AKIN II or III) were recorded immediately before transplantation and after surgery until hospital discharge. We evaluated the incidence density rate (IDR) of graft failure and the time to graft failure in patients with persistent or progressive AKI (
RESULTS
RESULTS
Two hundred seventy-nine patients received 301 deceased donor liver allografts. Progressive or persistent AKI was documented in more than half of transplant cases (152/301). The rate of graft loss was 3 times higher in the
CONCLUSIONS
CONCLUSIONS
Persistent or progressive AKI after liver transplantation is associated with an increased incidence rate of graft failure and is an independent predictor of decreased graft survival time.
Identifiants
pubmed: 30882034
doi: 10.1097/TXD.0000000000000868
pii: TXD50344
pmc: PMC6411224
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e429Déclaration de conflit d'intérêts
E.Y. has no conflict of interest with this work. Outside of this work, E.Y. has been an investigator of clinical trials sponsored by Gilead Sciences, Merck Inc, AbbVie Inc, Janssen Inc, Intercept Inc, Genfit Inc, Springbank Inc. He has received honoraria for CME/Ad Board lectures sponsored by Gilead Canada, Merck Canada, Abbvie Canada, Intercept Canada, Celgene Canada. V.M. has no conflict of interest with this work. V.M. is an investigator in the CONFIRM clinical trial comparing Terlipressin versus placebo in hepatorenal syndrome. He has received honoraria for CME/Ad Board from Merck Canada, Abbvie Canade and Janssen Inc. He has received training support from Intercept Inc and Astellas Inc. The other authors declare no conflicts of interest.
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