Open AccessHepatic ischemia reperfusion injury is associated with acute kidney injury following donation after brain death liver transplantation
Author(s) -
Leithead Joanna A.,
Armstrong Matthew J.,
Corbett Christopher,
Andrew Mark,
Kothari Chirag,
Gunson Bridget K.,
Muiesan Paolo,
Ferguson James W.
Publication year - 2013
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12175
Subject(s) - medicine , liver transplantation , acute kidney injury , creatinine , gastroenterology , transplantation , reperfusion injury , incidence (geometry) , ischemia , univariate analysis , cardiology , multivariate analysis , physics , optics
Summary Donation after cardiac death liver transplant recipients have an increased frequency of acute kidney injury (AKI). This suggests that hepatic ischemia‐reperfusion injury may play a critical role in the pathogenesis of AKI after liver transplantation. The aim of this single‐center study was to determine if hepatic ischemia‐reperfusion injury, estimated by peak peri‐operative serum amino‐transferase ( AST ), is associated with AKI following donation after brain death ( DBD ) liver transplantation. A total of 296 patients received 298 DBD liver transplants from January 2007 to June 2011. The incidence of AKI was 35.9%. AKI was a risk factor for chronic kidney disease ( P = 0.037) and mortality ( P = 0.002). On univariate analysis, peak AST correlated with peak creatinine ( P < 0.001) and peak change in creatinine from baseline ( P < 0.001). Peak AST was higher in AKI patients ( P < 0.001). The incidence of AKI in patients with a peak AST of <1500, 1500–2999 and ≥3000 U/l was 26.1%, 39.8% and 71.2%, respectively ( P < 0.001). On multiple logistic regression analysis, peak AST was independently associated with the development of AKI ( P < 0.001). In conclusion, hepatic ischemia‐reperfusion injury demonstrates a strong relationship with peri‐operative AKI in DBD liver transplant recipients.