Continuous venovenous hemodialysis treatment in critically ill patients after liver transplantation
Authors: Peter Lutkes, Jens Lutz, Jan Loock, Anton Daul, Christoph Broelsch, Thomas Philipp, Uwe Heemann
Journal: Kidney International (1999)

Continuous venovenous hemodialysis treatment in critically ill patients after liver transplantation.BackgroundAcute renal failure (ARF) in critically ill patients is associated with a high mortality rate. Continuous renal replacement therapy (CRRT) is now widely used for the treatment of ARF in these critically ill patients. We retrospectively analyzed the role of CRRT as a prognostic parameter in patients receiving a cadaveric liver graft in 1998.MethodsWe reviewed the patient records of all adult recipients of a cadaveric liver graft (N = 54) in 1998 and compared those who underwent CRRT treatment (N = 19) to those without CRRT treatment (N = 35).ResultsMortality was high in the continuous venovenous hemodialysis (CVVHD) group (58%). At the time of transplantation, creatinine (1.7 ± 0.4 vs. 1.0 ± 0.1 mg/dl), blood urea nitrogen (40 ± 13 vs. 22 ± 3 mg/dl), aspartate aminotransferase (ASAT; 585 ± 420 vs. 242 ± 97 U/liter), and bilirubin (11.6 ± 4.1 vs. 6.5 ± 1.9 mg/dl) were higher in the CVVHD group than in controls, whereas hemoglobin (10.3 ± 0.6 vs. 10.8 ± 0.4 g/dl), white blood cells (6.3 ± 0.6 vs. 7.0 ± 0.8/nl), and thrombocytes (110 ± 18 vs. 90 ± 10/nl) were similar. After transplantation, liver graft function was impaired in the CVVHD group as compared with controls.ConclusionsThe necessity for CRRT in patients after liver transplantation correlates with a high risk of death. Thus, more efforts have to be made to prevent renal failure in patients after liver transplantation. Continuous venovenous hemodialysis treatment in critically ill patients after liver transplantation. Acute renal failure (ARF) in critically ill patients is associated with a high mortality rate. Continuous renal replacement therapy (CRRT) is now widely used for the treatment of ARF in these critically ill patients. We retrospectively analyzed the role of CRRT as a prognostic parameter in patients receiving a cadaveric liver graft in 1998. We reviewed the patient records of all adult recipients of a cadaveric liver graft (N = 54) in 1998 and compared those who underwent CRRT treatment (N = 19) to those without CRRT treatment (N = 35). Mortality was high in the continuous venovenous hemodialysis (CVVHD) group (58%). At the time of transplantation, creatinine (1.7 ± 0.4 vs. 1.0 ± 0.1 mg/dl), blood urea nitrogen (40 ± 13 vs. 22 ± 3 mg/dl), aspartate aminotransferase (ASAT; 585 ± 420 vs. 242 ± 97 U/liter), and bilirubin (11.6 ± 4.1 vs. 6.5 ± 1.9 mg/dl) were higher in the CVVHD group than in controls, whereas hemoglobin (10.3 ± 0.6 vs. 10.8 ± 0.4 g/dl), white blood cells (6.3 ± 0.6 vs. 7.0 ± 0.8/nl), and thrombocytes (110 ± 18 vs. 90 ± 10/nl) were similar. After transplantation, liver graft function was impaired in the CVVHD group as compared with controls. The necessity for CRRT in patients after liver transplantation correlates with a high risk of death. Thus, more efforts have to be made to prevent renal failure in patients after liver transplantation.