Persistent Progressive Acute Kidney Injury and Graft Failure Post Liver Transplantation
1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
2Faculty of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
3Faculty of Medicine, Division of Surgery, University of British Columbia, Vancouver, BC, Canada
4Liver Transplant Program, Vancouver General Hospital, Vancouver, BC, Canada.
Meeting: 2018 American Transplant Congress
Abstract number: D205
Keywords: Graft failure, Liver grafts, Renal dysfunction
Session Information
Session Name: Poster Session D: Liver - Kidney Issues in Liver Transplantation
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background:
Acute kidney injury (AKI) in the setting of liver transplantation (LT) is a common and multifaceted complication. Recently, with the widespread adaptation of Acute Kidney Injury Network (AKIN) criteria, it has become possible to more reliably characterize the incidence and risk factors for AKI and to delineate its impact on patient outcomes. Our primary objective was to determine the impact of pre-and post-transplant AKI on graft survival, focusing on AKI episodes that progress or fail to resolve after liver transplantation.
Methods:
In this retrospective study, medical charts of all patients who received a liver transplant between Jan 2011 to Dec 31, 2015, at a single Canadian transplant centre, were reviewed. Moderate to severe AKI episodes (AKIN stage 2 or 3) were recorded immediately prior to transplantation and after surgery until hospital discharge. Persistent progressive AKI (ppAKI) was defined as an episode of moderate to severe AKI that worsened or did not resolve post transplantation. Patients who did not develop AKI or their AKI episode resolved post-LT were considered as controls. We evaluated the incidence density rate (IDR) of graft failure and the time to graft failure in patients with ppAKI as compared to controls.
Results:
279 patients received 301 deceased donor liver allografts. Prior to transplantation, 23% developed AKI while post-LT, more than half developed AKI (157/301). ppAKI was documented in more than half of transplant cases (152/301). A number of patient, donor and intra-operative variables were associated with ppAKI. Fifty cases of graft failure occurred in ppAKI group versus 22 in controls. The IDR of graft failure was 17.48 and 6.27 per 100 case-years in the ppAKI group as compared to the controls (IDR ratio 2.78 CI 1.65-4.83). After adjusting for hepatic artery thrombosis, ischemic cholangiopathy and MELD, ppAKI was associated with a decreased graft survival time
Conclusion:
Progressive or persistent AKI after liver transplantation is associated with an increased incidence rate of graft failure and is an independent predictor of decreased graft survival time.
CITATION INFORMATION: Hussaini T., Partovi N., Yoshida E., Erb S., Scudammore C., Chung S., Marquez V. Persistent Progressive Acute Kidney Injury and Graft Failure Post Liver Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Hussaini T, Partovi N, Yoshida E, Erb S, Scudammore C, Chung S, Marquez V. Persistent Progressive Acute Kidney Injury and Graft Failure Post Liver Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/persistent-progressive-acute-kidney-injury-and-graft-failure-post-liver-transplantation/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress