Incidence, Risk Factors, and Risk Model of Acute Kidney Injury After Liver Transplantation

Study Overview
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Brief Summary
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The incidence of acute kidney injury after liver transplantation has been reported to be 17 to 95 percent, but no definite treatment has been reported yet. Therefore, it is important to identify and prevent reversible risk factors for acute kidney injury after liver transplantation. Previous studies have reported several preoperative clinical risk factors, but preoperative medication and intraoperative colloid administration and hemodynamic parameters have not been evaluated. Therefore, we attempt to evaluate perioperative risk factors and develop simplified clinical risk scoring model.

Detailed Description
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Ischemia/reperfusion injury occurs during graft harvesting, cold storage, and surgical procedures in liver transplantation. Ischemia/reperfusion injury in liver graft results in major organ damage including kidney, lung and heart as well as graft dysfunction. Graft dysfunction and renal injury after liver transplantation are major clinical issues and are associated with prognosis and low survival rate. The incidence of acute kidney injury after liver transplantation has been reported to be 17 to 95 percent, but no definite treatment has been reported yet. Therefore, it is important to identify and prevent reversible risk factors for acute kidney injury after liver transplantation. Previous studies have reported several preoperative clinical risk factors, but perioperative medication, metabolic variables (albumin, glucose, uric acid), intraoperative colloid administration and hemodynamic parameters have not been evaluated. In addition, a neutrophil-lymphocyte ratio (NLR), which has been reported to be related to systemic inflammation and associated with prognosis of cardiac and cancer patients, might be related to the development of AKI after LDLT. Therefore, we attempt to evaluate these perioperative risk factors and develop simplified clinical risk scoring model.

Official Title
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Incidence, Risk Factors, and Risk Model of Acute Kidney Injury After Liver Transplantation

Conditions
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Renal Function, Liver Transplantation

Intervention / Treatment
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* Procedure: living donor liver transplantation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who underwent living donor liver transplantation between 2010 and 2013 in Samsung Medical Center Exclusion Criteria: Incomplete data regarding pre- and postoperative creatinine and estimated Glomerular Filtration Rate patient who underwent retransplantation

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| liver transplantation<br>patients who underwent living donor liver transplantation during between 2007 and 2013 | Procedure: living donor liver transplantation<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| acute kidney injury as defined by RIFLE criteria | acute kidney injury as defined by RIFLE criteria | during 7 days after transplantation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of renal replacement therapy | renal replacement therapy | during one month after transplantation | 
| incidence of acute rejection of graft | incidence of acute rejection of graft | during one month after transplantation | 
| incidence of initial poor graft function | incidence of initial poor graft function | during one month after transplantation | 
| incidence of retransplantation | incidence of retransplantation | during one month after transplantation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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risk factor, acute kidney injury, liver transplantation, postoperative renal function