Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Acute kidney injury(AKI)after liver transplantation (LT) is common.Calcineurin inhibitors(CNI)have to be well-balanced.The aims were analyze the specific effect of CNI on AKI in a cohort of patients and to analyze the profile of AKI-RIFLE categories in the post-LT setting and its impact on post-transplant-survival.A retrospective analysis of 400 patients transplanted at Reina Sofia and King's College Hospital was performed.Exclusion criteria were paediatric transplants,death<14 days and CNI-free regimes.Endpoints were: Development of AKI and 1-year survival.Incidence of AKI-Risk-Injury-Failure in the first 2 weeks after LT was 59,8, 34,3 and 8,4%.The development of any AKI had no impact on overall 1-year survival.In multivariate analysis,transfusions(OR=1,15[1,04-1,3]),peak-postLT-transaminases(OR=2,9[1,01-8,77],pretransplant eGFR(OR=10,54[1,88-59,1])and normal-CNI-dose strategies(OR=0,29[0,14-0,61])were independent predictors of AKI_Risk.Peak post-LT-transaminases(OR=3,3[1,39-7,8])and normal-CNI-dose strategies(OR=0,31[0,15-0,62])were predictors of AKI_Injury.Only peak post-LT-transaminases(OR=6,8[2,6-16,8])was a predictor of AKI_Failure.In the general linear models,strategies with low-CNI doses were only useful to prevent severe impairment in patients with extremely-low pre-transplant eGFR.AKI is frequent after LT.Transfusion, immediate liver function, pretx status and IS are factors that predict mild AKI.However,only immediate liver function predicts severe AKI.AKI happens similarly in all pre-tx eGFR status groups.Low CNI regimes are mildly useful in severely impaired eGFR pretx status patients being useless when pretransplant normal kidney function is preserved
To cite this abstract in AMA style:Bru RCiria, Luque IGómez, Cerisuelo MCortés, Cillero PLópez, O'Grady J, Mata Mdela, Heaton N, Delgado JBriceño. Acute Kidney Injury in the MELD Era of Liver Transplantation. Are Calcineurin Inhibitors So Problematic for Renal Function? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/acute-kidney-injury-in-the-meld-era-of-liver-transplantation-are-calcineurin-inhibitors-so-problematic-for-renal-function/. Accessed May 27, 2020.
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