Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases
Introduction. The possible risk factors for chronic kidney disease in transplant recipients have not been thoroughly investigated after living-donor liver transplantation. Material and Methods. A retrospective cohort study of consecutive adults who underwent living-donor liver transplantation betwee...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2018/5910372 |
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| author | Ehab E. Abdel-Khalek Alrefaey K. Alrefaey Amr M. Yassen Ahmed Monier Hesham M. Elgouhari Mohamed Samy Habl Gehad Tawfik Thuraya Elzayat Reham Adly Zayed Mohamed Abdel-Wahab |
| author_facet | Ehab E. Abdel-Khalek Alrefaey K. Alrefaey Amr M. Yassen Ahmed Monier Hesham M. Elgouhari Mohamed Samy Habl Gehad Tawfik Thuraya Elzayat Reham Adly Zayed Mohamed Abdel-Wahab |
| author_sort | Ehab E. Abdel-Khalek |
| collection | DOAJ |
| description | Introduction. The possible risk factors for chronic kidney disease in transplant recipients have not been thoroughly investigated after living-donor liver transplantation. Material and Methods. A retrospective cohort study of consecutive adults who underwent living-donor liver transplantation between May 2004 and October 2016, in a single center, was conducted. Kidney function was investigated successively for all the patients throughout the study period, with 12 months being the shortest follow-up. Postoperative renal dysfunction was defined in accordance with the Chronic Kidney Disease Epidemiology Collaboration criteria. The patients’ demographic data, preoperative and intraoperative parameters, and outcomes were recorded. A calcineurin inhibitor-based immunosuppressive regimen, either tacrolimus or cyclosporine, was used in all the patients. Results. Of the 413 patients included in the study, 33 (8%) who survived for ≥1 year experienced chronic kidney disease 1 year after living-donor liver transplantation. Twenty-seven variables were studied to compare between the patients with normal kidney functions and those who developed chronic kidney disease 1 year after living-donor liver transplantation. Univariate regression analysis for predicting the likelihood of chronic kidney disease at 1 year revealed that the following 4 variables were significant: operative time, P < 0.0005; intraoperative blood loss, P < 0.0005; preoperative renal impairment, P = 0.001; and graft-to-recipient weight ratio (as a negative predictor), P < 0.0005. In the multivariate regression analysis, only 2 variables remained as independent predictors of chronic kidney disease at 1 year, namely, operative time with a cutoff value of ≥714 minutes and graft-to-recipient weight ratio as a negative predictor with a cutoff value of <0.91. Conclusion. In this study, prolonged operative time and small graft-to-recipient weight ratio were independent predictors of chronic kidney disease at 1 year after living-donor liver transplantation. |
| format | Article |
| id | doaj-art-3231b293c8d14f3681e0474a09298fe9 |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-3231b293c8d14f3681e0474a09298fe92025-02-03T01:30:34ZengWileyJournal of Transplantation2090-00072090-00152018-01-01201810.1155/2018/59103725910372Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 CasesEhab E. Abdel-Khalek0Alrefaey K. Alrefaey1Amr M. Yassen2Ahmed Monier3Hesham M. Elgouhari4Mohamed Samy Habl5Gehad Tawfik6Thuraya Elzayat7Reham Adly Zayed8Mohamed Abdel-Wahab9Liver Transplantation Unit and Department of Internal Medicine, Faculty of Medicine, University of Mansoura, Mansoura, EgyptDepartment of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, University of Mansoura, Mansoura, EgyptDepartment of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, University of Mansoura, Mansoura, EgyptLiver Transplantation Unit and Gastroenterology Center, Faculty of Medicine, University of Mansoura, Mansoura, EgyptDepartment of Internal Medicine, Sanford School of Medicine, University of South Dakota, USALiver Transplantation Unit and Department of Internal Medicine, Faculty of Medicine, University of Mansoura, Mansoura, EgyptHouse Officer, University of Mansoura, Mansoura, EgyptHouse Officer, University of Mansoura, Mansoura, EgyptLiver Transplantation Unit and Department of Internal Medicine, Faculty of Medicine, University of Mansoura, Mansoura, EgyptLiver Transplantation Unit and Gastroenterology Center, Faculty of Medicine, University of Mansoura, Mansoura, EgyptIntroduction. The possible risk factors for chronic kidney disease in transplant recipients have not been thoroughly investigated after living-donor liver transplantation. Material and Methods. A retrospective cohort study of consecutive adults who underwent living-donor liver transplantation between May 2004 and October 2016, in a single center, was conducted. Kidney function was investigated successively for all the patients throughout the study period, with 12 months being the shortest follow-up. Postoperative renal dysfunction was defined in accordance with the Chronic Kidney Disease Epidemiology Collaboration criteria. The patients’ demographic data, preoperative and intraoperative parameters, and outcomes were recorded. A calcineurin inhibitor-based immunosuppressive regimen, either tacrolimus or cyclosporine, was used in all the patients. Results. Of the 413 patients included in the study, 33 (8%) who survived for ≥1 year experienced chronic kidney disease 1 year after living-donor liver transplantation. Twenty-seven variables were studied to compare between the patients with normal kidney functions and those who developed chronic kidney disease 1 year after living-donor liver transplantation. Univariate regression analysis for predicting the likelihood of chronic kidney disease at 1 year revealed that the following 4 variables were significant: operative time, P < 0.0005; intraoperative blood loss, P < 0.0005; preoperative renal impairment, P = 0.001; and graft-to-recipient weight ratio (as a negative predictor), P < 0.0005. In the multivariate regression analysis, only 2 variables remained as independent predictors of chronic kidney disease at 1 year, namely, operative time with a cutoff value of ≥714 minutes and graft-to-recipient weight ratio as a negative predictor with a cutoff value of <0.91. Conclusion. In this study, prolonged operative time and small graft-to-recipient weight ratio were independent predictors of chronic kidney disease at 1 year after living-donor liver transplantation.http://dx.doi.org/10.1155/2018/5910372 |
| spellingShingle | Ehab E. Abdel-Khalek Alrefaey K. Alrefaey Amr M. Yassen Ahmed Monier Hesham M. Elgouhari Mohamed Samy Habl Gehad Tawfik Thuraya Elzayat Reham Adly Zayed Mohamed Abdel-Wahab Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases Journal of Transplantation |
| title | Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases |
| title_full | Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases |
| title_fullStr | Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases |
| title_full_unstemmed | Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases |
| title_short | Renal Dysfunction after Living-Donor Liver Transplantation: Experience with 500 Cases |
| title_sort | renal dysfunction after living donor liver transplantation experience with 500 cases |
| url | http://dx.doi.org/10.1155/2018/5910372 |
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