Perioperative Risk Factors for Early Acute Kidney Injury After Living Donor Liver Transplantation: A Single Transplant Center in Vietnam

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.05.022

Ngo Dinh Trung MD, PhD , Do Van Nam , Nguyen Thi Thu , Nguyen Tai Thu , Ho Nam , Hoang Xuan Su

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引用次数: 0

Abstract

Background

Early acute kidney injury (AKI) is a frequent and severe complication following liver transplantation, significantly influencing both short-term and long-term outcomes of liver transplant recipients. However, data regarding perioperative risk factors for AKI in living donor liver transplantation remain limited.

Methods

This retrospective study analyzed 97 adult patients who underwent living donor liver transplantation at Central Military Hospital 108, Hanoi, Vietnam. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria. Clinical and laboratory data were recorded from the electronic medical profile. The risk factors for AKI development were recognized using logistic regression analysis.

Results

Among 97 liver transplant recipients, the incidence of AKI post LT was 63.9% (62/97). Preoperative MELD score (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.01–1.13; P = .019), cold ischemia time (OR, 1.03; 95% CI, 1.00–1.07; P = .050), intraoperative blood loss volume (OR, 1.81; 95% CI, 1.05–3.09; P = .032), and serum lactate within the first 6 hours after transplant (OR, 1.61; 95% CI, 1.21–2.15; P = .001) were identified as independent risk factors for early AKI. Patients with AKI experienced prolonged intensive care unit and hospital stays, higher rates of renal replacement therapy, and increased 1-year post-transplant mortality compared with non-AKI patients.

Conclusion

Preoperative Model for End-Stage Liver Disease score, cold ischemia time, intraoperative blood loss, and early postoperative serum lactate levels are independent risk factors for early AKI. Early AKI is associated with worse clinical outcomes, underscoring the importance of targeted interventions to mitigate the risk of AKI development.

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活体肝移植术后早期急性肾损伤的围手术期危险因素：越南单一移植中心。

背景：早期急性肾损伤（AKI）是肝移植术后常见且严重的并发症，对肝移植受者的近期和远期预后均有显著影响。然而，关于活体供肝移植围手术期AKI危险因素的数据仍然有限。方法：本回顾性研究分析了在越南河内第108军区中央医院接受活体肝移植的97例成人患者。AKI由肾脏疾病：改善全球结局标准定义。从电子医疗档案中记录临床和实验室数据。使用logistic回归分析识别AKI发展的危险因素。结果：97例肝移植受者中，肝移植后AKI发生率为63.9%（62/97）。术前MELD评分(优势比[OR]， 1.07；95%置信区间[CI]， 1.01-1.13；P = 0.019)、冷缺血时间(OR, 1.03；95% ci, 1.00-1.07；P = 0.050)，术中失血量(OR, 1.81；95% ci, 1.05-3.09；P = 0.032)，移植后前6小时血清乳酸水平(OR, 1.61；95% ci, 1.21-2.15；P = .001)是早期AKI的独立危险因素。与非AKI患者相比，AKI患者经历了较长的重症监护病房和住院时间，较高的肾脏替代治疗率，移植后1年死亡率增加。结论：术前终末期肝病模型评分、冷缺血时间、术中出血量、术后早期血清乳酸水平是早期AKI的独立危险因素。早期AKI与较差的临床结果相关，强调了靶向干预以减轻AKI发展风险的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

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.