Correlation Between Serum Transaminase Levels and Estimated Glomerular Filtration Rate After Living-Donor Kidney Transplantation

IF 0.8 4区 医学 Q4 IMMUNOLOGY
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引用次数: 0

Abstract

Background

There is a risk of hypoperfusion during kidney transplantation surgery owing to patients’ underlying disease and ischemia-reperfusion injury; further, hypoperfusion may cause injury to major organs. We hypothesized that the decrease in blood pressure after ischemia-reperfusion injury during kidney transplantation may be associated with indicators of liver injury and kidney graft function.

Methods

Data regarding living-donor kidney transplantations performed at our institution between 2018 and 2022 were retrospectively evaluated. Exclusion criteria included pediatric recipients or donors aged <18 years, multiple organ transplantation, and elevated postoperative serum transaminase levels. Correlations among blood pressure, serum transaminase levels on postoperative days 3 to 5, and estimated glomerular filtration rate (eGFR) on postoperative days 7 and 14 were analyzed. Further, a subgroup analysis was performed based on eGFR.

Results

A total of 276 patients were included in the final analysis. Serum transaminase levels were significantly negatively correlated with eGFR (partial correlation coefficient—0.26, P < .001). The postreperfusion decrease in blood pressure was not correlated with serum transaminase levels. However, the postreperfusion decrease in blood pressure and baseline blood pressure correlated with the eGFR (partial correlation coefficient = −0.18, P = .004).

Conclusion

These findings indicate a correlation between intraoperative liver injury and kidney graft function, suggesting the importance of intraoperative management of organ perfusion. Since postreperfusion blood pressure changes did not significantly correlate with liver injury indicators, it is important to consider other causative factors for hypoperfusion in major organs during living-donor kidney transplantation, including microcirculatory failure and organ congestion-related ischemia/reperfusion.

活体肾移植后血清转氨酶水平与估计肾小球滤过率之间的相关性
背景:肾移植手术期间,由于患者的基础疾病和缺血再灌注损伤,存在低灌注的风险;此外,低灌注可能会对主要器官造成损伤。我们假设,肾移植过程中缺血再灌注损伤后血压的下降可能与肝损伤指标和肾移植功能有关:回顾性评估了2018年至2022年在我院进行的活体肾移植数据。排除标准包括儿科受者或年龄较大的供体:共有 276 例患者纳入最终分析。血清转氨酶水平与 eGFR 呈显著负相关(部分相关系数-0.26,P < .001)。再灌注后血压下降与血清转氨酶水平无关。然而,再灌注后血压下降和基线血压与 eGFR 相关(部分相关系数 = -0.18,P = .004):这些研究结果表明,术中肝损伤与肾移植功能之间存在相关性,表明术中器官灌注管理的重要性。由于再灌注后血压变化与肝损伤指标无明显相关性,因此考虑活体肾移植过程中主要器官灌注不足的其他致病因素非常重要,包括微循环衰竭和器官充血相关的缺血/再灌注。
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来源期刊
Transplantation proceedings
Transplantation proceedings 医学-免疫学
CiteScore
1.70
自引率
0.00%
发文量
502
审稿时长
60 days
期刊介绍: Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.
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