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Risk factors for native kidney dysfunction in patients with abdominal multivisceral/small bowel transplantation
Author(s) -
Suzuki M.,
Mujtaba M. A.,
Sharfuddin A. A.,
Yaqub M. S.,
Mishler D. P.,
Faiz S.,
Vianna R. M.,
Mangus R. S.,
Tector J. A.,
Taber T. E.
Publication year - 2012
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/j.1399-0012.2012.01672.x
Subject(s) - medicine , tacrolimus , transplantation , kidney transplantation , renal function , kidney , kidney disease , gastroenterology , complication , liver transplantation , urology
Kidney dysfunction is a recognized complication after non‐renal solid organ transplantation, particularly after intestinal transplant. In our study, we reviewed data on 33 multivisceral transplant ( MVT )‐ and 15 isolated small bowel ( ISB )‐transplant patients to determine risk factors for kidney dysfunction. Kidney function was estimated by modified diet in renal disease ( MDRD ) and S chwartz formula for adults and children, respectively. Acute kidney injury ( AKI ) was defined as an increase in the serum C r ( sC r) greater than twofold. Kidney function declined significantly at one yr after transplantation with 46% of subjects showing an estimated GFR ( eGFR ) <60 mL/min. Patients with an episode of AKI were more likely to have reduced eGFR than those without AKI (p < 0.025). In linear regression analyses, age, pre‐transplant sC r, eGFR at postoperative day ( POD ) 30, 90, 180, 270, and tacrolimus level at POD 7 showed significant correlation with one yr post‐transplant eGFR (p < 0.05). Pediatric patients and patients with MVT had lesser decline in kidney function compared with adults or patients with ISB . In conclusion, risk factors for post‐transplant kidney dysfunction in intestinal transplantation included age, pre‐transplant sC r, AKI episode, eGFR at POD 30, 90, 180, 270, and tacrolimus level at POD 7.