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Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation

Early allograft dysfunction (EAD) identifies allografts with marginal function soon after liver transplantation (LT) and is associated with poor LT outcomes. The impact of EAD on post-LT renal recovery, however, has not been studied. Data on 69 primary LT recipients (41 with and 28 without history o...

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Autores principales: Wadei, Hani M., Lee, David D., Croome, Kristopher P., Mai, Lorraine, Leonard, Deanne, Mai, Martin L., Taner, C. Burcin, Keaveny, Andrew P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908457/
https://www.ncbi.nlm.nih.gov/pubmed/29707623
http://dx.doi.org/10.1097/TXD.0000000000000771
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author Wadei, Hani M.
Lee, David D.
Croome, Kristopher P.
Mai, Lorraine
Leonard, Deanne
Mai, Martin L.
Taner, C. Burcin
Keaveny, Andrew P.
author_facet Wadei, Hani M.
Lee, David D.
Croome, Kristopher P.
Mai, Lorraine
Leonard, Deanne
Mai, Martin L.
Taner, C. Burcin
Keaveny, Andrew P.
author_sort Wadei, Hani M.
collection PubMed
description Early allograft dysfunction (EAD) identifies allografts with marginal function soon after liver transplantation (LT) and is associated with poor LT outcomes. The impact of EAD on post-LT renal recovery, however, has not been studied. Data on 69 primary LT recipients (41 with and 28 without history of renal dysfunction) who received renal replacement therapy (RRT) for a median (range) of 9 (13-41) days before LT were retrospectively analyzed. Primary outcome was renal nonrecovery defined as RRT requirement 30 days from LT. Early allograft dysfunction developed in 21 (30%) patients, and 22 (32%) patients did not recover renal function. Early allograft dysfunction was more common in the renal nonrecovery group (50% vs 21%, P = 0.016). Multivariate logistic regression analysis demonstrated that EAD (odds ratio, 7.25; 95% confidence interval, 2.0-25.8; P = 0.002) and baseline serum creatinine (odds ratio, 3.37; 95% confidence interval, 1.4-8.1; P = 0.007) were independently associated with renal nonrecovery. History of renal dysfunction, duration of renal dysfunction, and duration of RRT were not related to renal recovery (P > 0.2 for all). Patients who had EAD and renal nonrecovery had the worst 1-, 3-, and 5-year patient survival, whereas those without EAD and recovered renal function had the best outcomes (P < 0.001). Post-LT EAD was independently associated with renal nonrecovery in LT recipients on RRT for a short duration before LT. Furthermore, EAD in the setting of renal nonrecovery resulted in the worst long-term survival. Measures to prevent EAD should be undertaken in LT recipients on RRT at time of LT.
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spelling pubmed-59084572018-04-27 Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation Wadei, Hani M. Lee, David D. Croome, Kristopher P. Mai, Lorraine Leonard, Deanne Mai, Martin L. Taner, C. Burcin Keaveny, Andrew P. Transplant Direct Liver Transplantation Early allograft dysfunction (EAD) identifies allografts with marginal function soon after liver transplantation (LT) and is associated with poor LT outcomes. The impact of EAD on post-LT renal recovery, however, has not been studied. Data on 69 primary LT recipients (41 with and 28 without history of renal dysfunction) who received renal replacement therapy (RRT) for a median (range) of 9 (13-41) days before LT were retrospectively analyzed. Primary outcome was renal nonrecovery defined as RRT requirement 30 days from LT. Early allograft dysfunction developed in 21 (30%) patients, and 22 (32%) patients did not recover renal function. Early allograft dysfunction was more common in the renal nonrecovery group (50% vs 21%, P = 0.016). Multivariate logistic regression analysis demonstrated that EAD (odds ratio, 7.25; 95% confidence interval, 2.0-25.8; P = 0.002) and baseline serum creatinine (odds ratio, 3.37; 95% confidence interval, 1.4-8.1; P = 0.007) were independently associated with renal nonrecovery. History of renal dysfunction, duration of renal dysfunction, and duration of RRT were not related to renal recovery (P > 0.2 for all). Patients who had EAD and renal nonrecovery had the worst 1-, 3-, and 5-year patient survival, whereas those without EAD and recovered renal function had the best outcomes (P < 0.001). Post-LT EAD was independently associated with renal nonrecovery in LT recipients on RRT for a short duration before LT. Furthermore, EAD in the setting of renal nonrecovery resulted in the worst long-term survival. Measures to prevent EAD should be undertaken in LT recipients on RRT at time of LT. Lippincott Williams & Wilkins 2018-03-14 /pmc/articles/PMC5908457/ /pubmed/29707623 http://dx.doi.org/10.1097/TXD.0000000000000771 Text en Copyright © 2018 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Liver Transplantation
Wadei, Hani M.
Lee, David D.
Croome, Kristopher P.
Mai, Lorraine
Leonard, Deanne
Mai, Martin L.
Taner, C. Burcin
Keaveny, Andrew P.
Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
title Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
title_full Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
title_fullStr Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
title_full_unstemmed Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
title_short Early Allograft Dysfunction Is Associated With Higher Risk of Renal Nonrecovery After Liver Transplantation
title_sort early allograft dysfunction is associated with higher risk of renal nonrecovery after liver transplantation
topic Liver Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908457/
https://www.ncbi.nlm.nih.gov/pubmed/29707623
http://dx.doi.org/10.1097/TXD.0000000000000771
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