Acute Kidney Injury Common After Liver Transplantation
Even mild cases of acute kidney injury after liver transplantation are associated with lower survival for both the patient and the graft.
Acute kidney injury often occurs after liver transplantation because of blood loss or surgery-related events. Previous studies have estimated the incidence rate at 17 to 95 percent—a wide range that reveals the lack of clear diagnostic criteria. To address this problem, researchers led by Yousri Barri of Baylor University Medical Center in Texas sought to find the optimal definition for acute kidney injury after liver transplantation, and determine its impact on patients’ long-term outcomes.
They retrospectively studied patients who underwent liver transplantation at Baylor between 1997 and 2005. The majority of liver transplant recipients experienced some degree of acute kidney injury.
“Even mild acute kidney injury defined as rise in serum creatinine of >0.5 mg/dL was associated with reduced patient and graft survival,” the authors report. However, the strictest definition of acute kidney injury was associated with the worst outcomes, including higher incidence of cardiovascular events and end-stage renal disease.
“This study shows that acute kidney injury, appropriately defined, has an important impact on long-term renal function and patient and graft survival post-liver transplantation,” the authors conclude. “Whether acute kidney injury is the direct cause or simply associated with poor outcome will need further study.”