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. 2017 Aug;96(31):e7626.
doi: 10.1097/MD.0000000000007626.

Influence of oxygen content immediately after graft reperfusion on occurrence of postoperative acute kidney injury in living donor liver transplantation

Min Suk Chae  1 , Nuri Lee, Da Hye Park, Jisoo Lee, Hyun Sik Jung, Chul Soo Park, Jaemin Lee, Jong Ho Choi, Sang Hyun Hong
Affiliations

Influence of oxygen content immediately after graft reperfusion on occurrence of postoperative acute kidney injury in living donor liver transplantation

Min Suk Chae et al. Medicine (Baltimore). 2017 Aug.

Abstract

Acute kidney injury (AKI) is a common complication after living donor liver transplantation (LDLT). In this study, we investigated perioperative factors, including oxygen content, related to the postoperative development of AKI after LDLT. The perioperative data of 334 patients were reviewed retrospectively. We identified the postoperative development of AKI based on the Acute Kidney Injury Network criteria. Perioperative variables, including oxygen content, were compared between patients with and without AKI. Potentially significant variables in a univariate analysis were evaluated by multivariate analysis. Postoperative AKI developed in 76 patients (22.7%). Univariate analysis revealed that preoperative factors (body mass index [BMI], diabetes mellitus, C-reactive protein) and intraoperative factors (severe postreperfusion syndrome, packed red blood cell transfusion, furosemide, and oxygen content at the anhepatic phase, 5 minutes and 1 hour after graft reperfusion, and at peritoneal closure) of recipients were significant. The multivariate analysis showed that oxygen content 5 minutes after graft reperfusion, BMI, and furosemide administration were independently associated with postoperative AKI. In conclusion, postoperative AKI was independently associated with oxygen content 5 minutes after graft reperfusion, BMI, and furosemide administration. Meticulous ventilator care and transfusion should be required to maintain sufficient oxygen content immediately after graft reperfusion in patients who undergo LDLT.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of the oxygen content between recipients with/without postoperative acute kidney injury (AKI) during living donor liver transplantation. The box plots show the median (line in the middle of the box), interquartile range (box), 10th and 90th percentiles (whiskers), and outliers (dots). ∗P = .004, non-AKI group vs. AKI group by Bonferroni post hoc test.
Figure 2
Figure 2
Comparison of oxygen contents at 5 minutes after graft reperfusion according to the severity of postoperative acute kidney injury (AKI) in living donor liver transplantation. The box plots show the median (line in the middle of the box), interquartile range (box), 10th and 90th percentiles (whiskers), and outliers (dots). ∗P = .032, non-AKI vs. AKI stage I; ∗∗P = .015, non-AKI vs. AKI stage II or III by Bonferroni post hoc test.
See this image and copyright information in PMC

References

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