Frequency of Acute Kidney Injury Following Liver Transplant and Factors Associated With AKI

Abstract

Objective: This study aimed to determine AKI frequency in post-liver transplant patients and the factors associated with AKI.

Methodology: A cross-sectional study was conducted in the Department of Nephrology, Shifa International Hospital, Islamabad. Permission was obtained from the hospital ethics committee and written informed consent was administered to all 367 study patients. Information during surgery (blood loss, cold and warm ischemia time) was recorded. Serum creatinine was measured 24 hourly in all recipients during their postoperative hospital stay. All the data collection was conducted by the researcher himself to maintain data quality and compliance with the study protocol.  The data was analyzed in SPSS software version 20.0.

Results:  The mean age was 51.5 ± 9.6 years. There were 213 (58%) males and 154 (42%) females cases. After liver transplant, 10 (2.7%) cases had acute kidney injury. There were 128 (34.9%) cases who had the presence of comorbidity, 122 (33.2%) cases had blood loss > 2500 ml, 125 (34.1%) cases had warm ischemia time >10 minutes and 110 (30%) cases had cold ischemia time >7 hours. AKI was associated with comorbidity, blood loss >2500 ml, warm ischemia time >10 min, and cold ischemia time of >7 hours (p-value <0.05).

Conclusion: The frequency of AKI following post-liver transplant was less though, but it was higher in factors that can be controlled before, during, or after the liver transplant. Hence, by managing the preoperative morbidities, controlling blood loss, and warm and cold ischemia time we can prevent post-liver transplant acute kidney injury.