Derivation and Prospective External Validation of Prediction Models for Acute Kidney Injury in Adult Liver Transplant Recipients
1Organ Transplant Center, The First Affiliated Hospital of Sun Yet-sen University, Guangzhou, China
2Department of Hepatobiliary Surgery, Guangdong General Hospital, Guangzhou, China
3Organ Transplant Department, The Eastern Hospital of the First Affiliated Hospital of SYSU, Guangzhou, China
4Department of Hepatobiliary Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China.
Meeting: 2018 American Transplant Congress
Abstract number: D210
Keywords: Kidney, Liver transplantation
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) is common in patients after liver transplantation, and has a marked impact on the perioperative and long-term morbidity and mortality. However, no risk-prediction tools have been developed to identify high-risk patients before liver transplantation.
METHODS: The risk models were derived from patients (n=439) undergoing first-single-organ adult liver transplantation for chronic liver disease at our center 01/2013-10/2016. Only donor and recipient factors known before transplantation were chosen so that the probabilities of AKI could be calculated before transplantation and appropriate preventative measures taken. Patients missing one or more candidate predictors (n =148) were excluded. By means of a multivariable logistic regression analysis, factors contributing to AKI in the remaining 291 patients were identified. The risk models were then prospectively external validated with data from patients at other 3 centers in China transplanted at 11/2016-03/2017 (n=115).
RESULTS: The incidence of AKI was 44.3%. We identified independent prognostic factors for AKI including recipient's factors: preoperative serum white blood cell count, platelet count, prothrombin time and donor's factors: age, blood urea nitrogen, aspartate aminotransferase, sodium and white blood cell count. In the validation cohort, a multivariable model including these 8 variables had a C statistic of 0.80 (95% CI, 0.68-0.91). The non-AKI, grade 1, 2,3 AKI were associated with a significantly different in 1 and 3 year overall survival (98.4% vs 93.3% vs 78.6% vs 70.4%, p<0.05 and 95.6% vs 84.8% vs 78.6% vs 70.4%, p<0.05).
CONCLUSION: A multivariable model using routine laboratory data was able to predict AKI after liver transplantation. With this index in hand, better informed treatment and patient selection can be made.
CITATION INFORMATION: Zhao Q., Guo Z., Chen M., Ma S., Lin J., Zhang C., Han M., He X. Derivation and Prospective External Validation of Prediction Models for Acute Kidney Injury in Adult Liver Transplant Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Zhao Q, Guo Z, Chen M, Ma S, Lin J, Zhang C, Han M, He X. Derivation and Prospective External Validation of Prediction Models for Acute Kidney Injury in Adult Liver Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/derivation-and-prospective-external-validation-of-prediction-models-for-acute-kidney-injury-in-adult-liver-transplant-recipients/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress