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Ischemia Reperfusion Injury in Liver Transplantation is Associated with Acute Kidney Injury: Role of Inflammatory Mediators

P. Mihaylov,1,2 P. Li,1 J. Skill,1 L. Timsina,1 J. Fridell,1 B. Ekser,1 R. Mangus,1 C. Kubal.1

1Surgery, Indiana University, Indianapolis
2Surgery, University of Pavia, Pavia, Italy.

Meeting: 2018 American Transplant Congress

Abstract number: 148

Keywords: Inflammation, Liver transplantation, Renal function, Risk factors

Session Information

Session Name: Concurrent Session: Liver - Kidney Issues in Liver Transplantation

Session Type: Concurrent Session

Date: Sunday, June 3, 2018

Session Time: 4:30pm-6:00pm

 Presentation Time: 5:06pm-5:18pm

Location: Room 6B

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).

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To cite this abstract in AMA style:

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 [abstract]. https://atcmeetingabstracts.com/abstract/ischemia-reperfusion-injury-in-liver-transplantation-is-associated-with-acute-kidney-injury-role-of-inflammatory-mediators/. Accessed May 18, 2025.

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