Background: The impact of liver allograft ischemia/reperfusion injury (IRI) on native renal function remains to be characterized. We hypothesized that elevated levels of circulating inflammatory mediators are associated with IRI and/or acute kidney injury (AKI) after liver transplantation (LT).

Methods: 55 adult patients receiving isolated LT between August 2016 and June 2017 were studied prospectively. AKI within 48 hours after LT was graded as per Kidney Disease: Improving Global Outcomes staging system. Surrogate marker for hepatic IRI was peak post-transplant AST level within the first 48 hours. Categorical classification of IRI based on peak AST (U/L): 1) minimal: <1000, 2) Mild: 1000-2000; 3) Moderate: >2000-5000 and 4) Severe: >5000. Renal function at 1-year post-transplant was noted as MDRD eGFR. Sera were collected on day 0 (before transplant), day 1, 7, 24, 21, 30 days. 38 cytokines/chemokines in sera were simultaneously measured. Logistic regression was applied to evaluate the association between AKI and IRI.

Results: IRI was observed in 49% patients [mild (41%), moderate (37%) and severe (22%)]. AKI was observed in 31% patients [stage 1(71%), stage 2(18%) & stage 3(12%)]. IRI was significantly associated with AKI (p<0.0001). Multiplex immunoassay results indicate that proinflammatory cytokines/chemokines TNFα, IL-6, IL-10 were significantly elevated in patients with IRI and AKI, compared to patients without IRI and AKI.

Conclusions: Post LT AKI is common and is strongly associated with IRI. Proinflammatory cytokines/chemokines such as TNFα, IL-6,may cause AKI. Maneuvers to prevent IRI and/or AKI may involve manipulation of inflammatory processes that may ultimately improve the outcomes.

CITATION INFORMATION: Mihaylov P., Li P., Skill J., Timsina L., Fridell J., Ekser B., Mangus R., Kubal C. Ischemia Reperfusion Injury in Liver Transplantation is Associated with Acute Kidney Injury: Role of Inflammatory Mediators Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress