aim of the study is to assess the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD) after liver transplantation (LT) in DCD vs. DBD recipients. methods: this is a retrospective single-centre study of 1151 patients who underwent LT from 2007 to 2014. exclusion criteria: urgent (=66) and living donor (=7) LT. We considered: renal function pre-LT, daily within one week post-operatively, at 1, 3, 4, 6, 9 months and 1, 3, 5 years post-LT, characteristics of recipient, donor type, graft variables and indicators of initial graft function. AKI and CKD defined and classified on the basis of KDIGO Guidelines (2012). results: we considered 1078 LT patients (830 DBD and 248 DCD). DBD recipients had a higher MELD (p=0.002) and pre-LT serum bilirubin level (p<0.001) than DCD but there were no differences in INR and serum creatinine values. DBD recipients had longer cold and recipient warm ischemia times than DCD (p<0.001 and p=0.018 respectively). The incidence of AKI was 57.9% (624/1078), of which 57.1% of DBD (474/830) vs. 60.5% of DCD (150/248). DCD recipients had a higher incidence of stage 3 AKI than DBD (20.6% vs. 12.7%, p=0.0197). Among patients with stage 3 AKI DCD had a higher cumulative incidence of CKD compared to DBD (SHR 1.6 (1.0-2.7), p=0.051). Conclusion: For the first time we showed that both DBD and DCD recipients suffer a similar degree of stage 1-2 of AKI, but the DCD experience more severe stage 3 AKI, which is associated with a higher incidence of CKD in the long-term follow-up.
Umbro, I., Tinti, F., Evison, F., Sharif, A., Gunson, B., Mitterhofer, A., et al. (2016). Acute kidney injury and chronic kidney disease in donation after circulatory death liver transplantation: UK single centre study. In AMERICAN JOURNAL OF TRANSPLANTATION (pp.233-234). Hoboken : Wiley-Blackwell.
Acute kidney injury and chronic kidney disease in donation after circulatory death liver transplantation: UK single centre study
Mitterhofer, A
;
2016-01-01
Abstract
aim of the study is to assess the incidence of acute kidney injury (AKI) and chronic kidney disease (CKD) after liver transplantation (LT) in DCD vs. DBD recipients. methods: this is a retrospective single-centre study of 1151 patients who underwent LT from 2007 to 2014. exclusion criteria: urgent (=66) and living donor (=7) LT. We considered: renal function pre-LT, daily within one week post-operatively, at 1, 3, 4, 6, 9 months and 1, 3, 5 years post-LT, characteristics of recipient, donor type, graft variables and indicators of initial graft function. AKI and CKD defined and classified on the basis of KDIGO Guidelines (2012). results: we considered 1078 LT patients (830 DBD and 248 DCD). DBD recipients had a higher MELD (p=0.002) and pre-LT serum bilirubin level (p<0.001) than DCD but there were no differences in INR and serum creatinine values. DBD recipients had longer cold and recipient warm ischemia times than DCD (p<0.001 and p=0.018 respectively). The incidence of AKI was 57.9% (624/1078), of which 57.1% of DBD (474/830) vs. 60.5% of DCD (150/248). DCD recipients had a higher incidence of stage 3 AKI than DBD (20.6% vs. 12.7%, p=0.0197). Among patients with stage 3 AKI DCD had a higher cumulative incidence of CKD compared to DBD (SHR 1.6 (1.0-2.7), p=0.051). Conclusion: For the first time we showed that both DBD and DCD recipients suffer a similar degree of stage 1-2 of AKI, but the DCD experience more severe stage 3 AKI, which is associated with a higher incidence of CKD in the long-term follow-up.File | Dimensione | Formato | |
---|---|---|---|
Umbro_Acute-kidney_2016.pdf
solo utenti autorizzati
Tipologia:
Versione Editoriale (PDF)
Licenza:
Copyright dell'editore
Dimensione
354 kB
Formato
Adobe PDF
|
354 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.