Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
Abstract. Early allograft dysfunction (EAD) identifies allografts with marginal function soon after liver transplantation (LT) and is associated with poor LT outcomes. The impact of EAD on post-LT renal recovery, however, has not been studied. Data on 69 primary LT recipients (41 with and 28 without...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2018-04-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000771 |
| _version_ | 1811334788946067456 |
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| author | Hani M. Wadei, MD David D. Lee, MD Kristopher P. Croome, MD, MS Lorraine Mai, BSN, CDE Deanne Leonard, MD Martin L. Mai, MD C. Burcin Taner, MD Andrew P. Keaveny, MD |
| author_facet | Hani M. Wadei, MD David D. Lee, MD Kristopher P. Croome, MD, MS Lorraine Mai, BSN, CDE Deanne Leonard, MD Martin L. Mai, MD C. Burcin Taner, MD Andrew P. Keaveny, MD |
| author_sort | Hani M. Wadei, MD |
| collection | DOAJ |
| description | Abstract. Early allograft dysfunction (EAD) identifies allografts with marginal function soon after liver transplantation (LT) and is associated with poor LT outcomes. The impact of EAD on post-LT renal recovery, however, has not been studied. Data on 69 primary LT recipients (41 with and 28 without history of renal dysfunction) who received renal replacement therapy (RRT) for a median (range) of 9 (13-41) days before LT were retrospectively analyzed. Primary outcome was renal nonrecovery defined as RRT requirement 30 days from LT. Early allograft dysfunction developed in 21 (30%) patients, and 22 (32%) patients did not recover renal function. Early allograft dysfunction was more common in the renal nonrecovery group (50% vs 21%, P = 0.016). Multivariate logistic regression analysis demonstrated that EAD (odds ratio, 7.25; 95% confidence interval, 2.0-25.8; P = 0.002) and baseline serum creatinine (odds ratio, 3.37; 95% confidence interval, 1.4-8.1; P = 0.007) were independently associated with renal nonrecovery. History of renal dysfunction, duration of renal dysfunction, and duration of RRT were not related to renal recovery (P > 0.2 for all). Patients who had EAD and renal nonrecovery had the worst 1-, 3-, and 5-year patient survival, whereas those without EAD and recovered renal function had the best outcomes (P < 0.001). Post-LT EAD was independently associated with renal nonrecovery in LT recipients on RRT for a short duration before LT. Furthermore, EAD in the setting of renal nonrecovery resulted in the worst long-term survival. Measures to prevent EAD should be undertaken in LT recipients on RRT at time of LT. |
| first_indexed | 2024-04-13T17:14:22Z |
| format | Article |
| id | doaj.art-0ec5bc4dea4f4c69abe220a0ba340673 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-04-13T17:14:22Z |
| publishDate | 2018-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-0ec5bc4dea4f4c69abe220a0ba3406732022-12-22T02:38:10ZengWolters KluwerTransplantation Direct2373-87312018-04-0144e35210.1097/TXD.0000000000000771201804000-0007Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver TransplantationHani M. Wadei, MD0David D. Lee, MD1Kristopher P. Croome, MD, MS2Lorraine Mai, BSN, CDE3Deanne Leonard, MD4Martin L. Mai, MD5C. Burcin Taner, MD6Andrew P. Keaveny, MD71 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.1 Mayo Clinic Collaborative in Transplant Research and Outcomes, Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.Abstract. Early allograft dysfunction (EAD) identifies allografts with marginal function soon after liver transplantation (LT) and is associated with poor LT outcomes. The impact of EAD on post-LT renal recovery, however, has not been studied. Data on 69 primary LT recipients (41 with and 28 without history of renal dysfunction) who received renal replacement therapy (RRT) for a median (range) of 9 (13-41) days before LT were retrospectively analyzed. Primary outcome was renal nonrecovery defined as RRT requirement 30 days from LT. Early allograft dysfunction developed in 21 (30%) patients, and 22 (32%) patients did not recover renal function. Early allograft dysfunction was more common in the renal nonrecovery group (50% vs 21%, P = 0.016). Multivariate logistic regression analysis demonstrated that EAD (odds ratio, 7.25; 95% confidence interval, 2.0-25.8; P = 0.002) and baseline serum creatinine (odds ratio, 3.37; 95% confidence interval, 1.4-8.1; P = 0.007) were independently associated with renal nonrecovery. History of renal dysfunction, duration of renal dysfunction, and duration of RRT were not related to renal recovery (P > 0.2 for all). Patients who had EAD and renal nonrecovery had the worst 1-, 3-, and 5-year patient survival, whereas those without EAD and recovered renal function had the best outcomes (P < 0.001). Post-LT EAD was independently associated with renal nonrecovery in LT recipients on RRT for a short duration before LT. Furthermore, EAD in the setting of renal nonrecovery resulted in the worst long-term survival. Measures to prevent EAD should be undertaken in LT recipients on RRT at time of LT.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000771 |
| spellingShingle | Hani M. Wadei, MD David D. Lee, MD Kristopher P. Croome, MD, MS Lorraine Mai, BSN, CDE Deanne Leonard, MD Martin L. Mai, MD C. Burcin Taner, MD Andrew P. Keaveny, MD Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation Transplantation Direct |
| title | Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation |
| title_full | Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation |
| title_fullStr | Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation |
| title_full_unstemmed | Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation |
| title_short | Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation |
| title_sort | early allograft dysfunction is associated with higher risk of renal nonrecovery after liver transplantation |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000771 |
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