PTU-057 Split liver transplant recipients are less likely to require peri-operative renal replacement therapy than full-size liver transplant controls: Abstract PTU-057 Table 1
Year: 2012
Type: conference-abstract
Abstract: Introduction Several small studies have suggested that split liver transplant (SLT) recipients have an increased frequency of peri-operative acute kidney injury (AKI). However, given that hepatic ischaemia-reperfusion injury may play a role in the pathogenesis of peri-transplant AKI, the optimal donor selection of split liver transplantation could have a favourable impact on renal outcomes. Our aim was to compare renal outcomes in SLT recipients with matched full-size liver transplant (FSLT) controls. Methods Single-centre study of 72 patients who received a SLT for chronic liver disease 01/2007–06/2011. 72 FSLT (Donation after Brain Death) controls were matched by propensity-risk-score. Definitions: AKI, peak creatinine ≥2 times baseline; chronic kidney disease (CKD), MDRD4 eGFR <60 ml/min/1.73 m 2 . Results SLT recipients and FSLT controls were well matched on confounders. Split liver grafts had a younger donor age (p<0.001), longer cold ischaemic time (p=0.026) but similar warm ischaemic time (p=0.213). There was no difference in the intra-operative red cell concentrate requirements between the groups (p=0.460). During the immediate post-operative period, the median peak AST was 1156 U/L for SLT recipients and 1124 U/L for FSLT controls (p=0.960). The frequency of re-laparotomy for bleeding (p=0.310), primary non-function (p=1.000), sepsis (p=0.643) and biliary complications were comparable (p=1.000). Estimated 3-year patient survival was 90.0% and 91.8% for SLT recipients and controls, respectively (log-rank p=0.400). Peri-operative and long-term renal outcomes are outlined in Abstract PTU-057 table 1. There was no difference between the two groups, with the exception of renal replacement therapy; SLT recipients were less likely to require peri-operative renal replacement therapy than FSLT controls (p=0.048). Abstract PTU-057 Table 1 Post transplant renal outcomes in SLT recipients and FSLT controls SLT FSLT p Value Peri-operative renal function Median peak creatinine (μmol/l) 113 116 0.585 Median change in creatinine from baseline (%) +27 +43.6 0.653 AKI (%) 29.2 34.7 0.475 Renal replacement therapy (%) 11.1 23.6 0.048 Long-term renal function Mean 1-month eGFR (ml/min/1.73 m 2 ) 83 81 0.773 3-year cumulative incidence of CKD (%) 32.5 28.7 0.534 Conclusion SLT recipients are less likely to require peri-operative renal replacement therapy than well matched FSLT recipients. Higher graft quality and/or smaller graft volume may have a beneficial renal-sparing effect. Competing interests None declared.
Source: Gut
Authors: J A Leithead, M J Armstrong, C Corbett, M Andrew, C Kothari, F Tinti, B K Gunson, D Mirza, P Muiesan, J W Ferguson
Institutions: Queen Elizabeth Hospital Birmingham, University of Birmingham
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2503624183