Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey
Background: Fluid administration is a critical component of perioperative management for liver transplant recipients, and excessive fluid infusion can lead to acute kidney injury (AKI) and poor patient outcomes.Method: We conducted a cross-sectional survey on the fluid intake and output of adult liv...
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Pharmaceutical Policy and Practice |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20523211.2024.2438225 |
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| author | Desheng Li Qinghua Guan Chuanlin Chen Bo Sheng Zhenyu Zhang Yongfang Hu |
| author_facet | Desheng Li Qinghua Guan Chuanlin Chen Bo Sheng Zhenyu Zhang Yongfang Hu |
| author_sort | Desheng Li |
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| description | Background: Fluid administration is a critical component of perioperative management for liver transplant recipients, and excessive fluid infusion can lead to acute kidney injury (AKI) and poor patient outcomes.Method: We conducted a cross-sectional survey on the fluid intake and output of adult liver transplant recipients over a 7-day period. The patients were divided into AKI and non-AKI groups. Multivariate logistic regression analyses were used to evaluate the association between fluid balance (FB) and AKI. A Kaplan-Meier survival analysis was performed to determine the survival of the recipient survival at 180 days.Results: A total of 210 liver transplant recipients were included. The peak FB occurred on the second day after transplantation, which was higher than on the seventh day (0.3 [IQR, −0.2 to 0.8] L vs. −0.4 [IQR, −1.0 to 0.3] L, p < 0.001). The highest incidence of AKI was observed on the second day after transplantation and the lowest on the seventh day (52.4% vs. 15.4%, p < 0.001). Multivariate analysis showed that a cumulative FB > 1 L within the first 2 days postoperatively was an independent risk factor for AKI on the second day after liver transplantation (LT) (OR = 2.66, 95% CI, 1.31–5.41, p = 0.007). Survival analysis indicated significant differences in 180-day survival rates among patients with different grades of AKI [94.0% (grade 1) vs. 91.4% (grade 2) vs. 77.8% (grade 3), χ2 = 12.93, p < 0.001].Conclusion: There is a significant correlation between post-LT AKI and perioperative FB. Cumulative FB > 1 L in the first 2 days postoperatively is an independent risk factor for AKI on the second day after LT. AKI after LT is associated with a lower 180-day survival rate in patients. |
| format | Article |
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| institution | OA Journals |
| issn | 2052-3211 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | Journal of Pharmaceutical Policy and Practice |
| spelling | doaj-art-44e539557bb7404fbe154a0cce5017c92025-08-20T01:58:12ZengTaylor & Francis GroupJournal of Pharmaceutical Policy and Practice2052-32112025-12-0118110.1080/20523211.2024.2438225Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional surveyDesheng Li0Qinghua Guan1Chuanlin Chen2Bo Sheng3Zhenyu Zhang4Yongfang Hu5School of Clinical Medicine, Qinghai University, Xining, People's Republic of ChinaLiver ICU, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of ChinaSchool of Clinical Medicine, Qinghai University, Xining, People's Republic of ChinaLiver ICU, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of ChinaLiver ICU, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of ChinaDepartment of Clinical Pharmacy, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People's Republic of ChinaBackground: Fluid administration is a critical component of perioperative management for liver transplant recipients, and excessive fluid infusion can lead to acute kidney injury (AKI) and poor patient outcomes.Method: We conducted a cross-sectional survey on the fluid intake and output of adult liver transplant recipients over a 7-day period. The patients were divided into AKI and non-AKI groups. Multivariate logistic regression analyses were used to evaluate the association between fluid balance (FB) and AKI. A Kaplan-Meier survival analysis was performed to determine the survival of the recipient survival at 180 days.Results: A total of 210 liver transplant recipients were included. The peak FB occurred on the second day after transplantation, which was higher than on the seventh day (0.3 [IQR, −0.2 to 0.8] L vs. −0.4 [IQR, −1.0 to 0.3] L, p < 0.001). The highest incidence of AKI was observed on the second day after transplantation and the lowest on the seventh day (52.4% vs. 15.4%, p < 0.001). Multivariate analysis showed that a cumulative FB > 1 L within the first 2 days postoperatively was an independent risk factor for AKI on the second day after liver transplantation (LT) (OR = 2.66, 95% CI, 1.31–5.41, p = 0.007). Survival analysis indicated significant differences in 180-day survival rates among patients with different grades of AKI [94.0% (grade 1) vs. 91.4% (grade 2) vs. 77.8% (grade 3), χ2 = 12.93, p < 0.001].Conclusion: There is a significant correlation between post-LT AKI and perioperative FB. Cumulative FB > 1 L in the first 2 days postoperatively is an independent risk factor for AKI on the second day after LT. AKI after LT is associated with a lower 180-day survival rate in patients.https://www.tandfonline.com/doi/10.1080/20523211.2024.2438225Liver transplantationcumulative fluid balancefluid managementacute kidney injuryperioperative |
| spellingShingle | Desheng Li Qinghua Guan Chuanlin Chen Bo Sheng Zhenyu Zhang Yongfang Hu Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey Journal of Pharmaceutical Policy and Practice Liver transplantation cumulative fluid balance fluid management acute kidney injury perioperative |
| title | Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey |
| title_full | Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey |
| title_fullStr | Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey |
| title_full_unstemmed | Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey |
| title_short | Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey |
| title_sort | relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes a cross sectional survey |
| topic | Liver transplantation cumulative fluid balance fluid management acute kidney injury perioperative |
| url | https://www.tandfonline.com/doi/10.1080/20523211.2024.2438225 |
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