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Interaction between tacrolimus, MELD score and acute kidney injury after liver transplantation. Analysis on a large contemporary bicenter meld‐era series
Author(s) -
Ciria Rubén,
GómezLuque Irene,
Cortés Miriam,
Khorsandi Shirin E.,
Ayllón Maria D.,
RodríguezPerálvarez Manuel,
LópezCillero Pedro,
De La Mata Manuel,
O'Grady John,
Heaton Nigel,
Briceño Javier
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13890
Subject(s) - medicine , rifle , acute kidney injury , liver transplantation , context (archaeology) , immunosuppression , incidence (geometry) , transplantation , tacrolimus , cohort , retrospective cohort study , surgery , paleontology , physics , archaeology , biology , optics , history
Background Acute kidney injury (AKI) after liver transplantation (LT) is a common problem with complex management. The aims were to analyze the profile of AKI‐RIFLE categories in the post‐transplant setting of a wide multicentre cohort of patients in the MELD era and to specifically determine the effect of tacrolimus‐based (TACRO) immunosuppressive regimes on the development of AKI. Methods A retrospective analysis of 550 (2007‐2012) consecutive patients transplanted at Reina Sofia, Cordoba, and King's College Hospital, London, was performed. Inclusion criterion was to have CNI as part of initial immunosuppression immediately after LT. Results After exclusion criteria, a total of 477 patients were analyzed. Incidence of AKI within the first 2 weeks after LT was 65.8% (AKI‐Risk), 41.3% (AKI‐Injury), and 12.3% (AKI‐Failure). The development of any type of AKI had no impact on short‐ and/or long‐term survival up to 3 years after the transplant. Moreover, AKI was almost universal in the early post‐transplant period and TACRO trough concentrations during the first 2 weeks after the transplant were not predictors of AKI in none of its categories in the multivariate analyses. Conclusions Low‐TACRO‐based regimes were not as useful as expected in the prevention of AKI when analyzed in the context of a large contemporary LT series.