کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6103896 1590326 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Research ArticleThe evolving use of higher risk grafts is associated with an increased incidence of acute kidney injury after liver transplantation
ترجمه فارسی عنوان
مقاله پژوهشی استفاده در حال رشد از گرافت های خطر بالاتری با افزایش بروز آسیب های حاد کلیه پس از پیوند کبد همراه است
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
چکیده انگلیسی

Background & AimsThe growing discrepancy between supply and demand for liver transplantation has necessitated a greater use of higher risk grafts. Donation after Circulatory Death (DCD) liver transplant recipients have an increased frequency of acute kidney injury (AKI). We hypothesised that other higher risk grafts might also impact negatively on renal function. Our aim was to examine the effect of the evolving use of higher risk grafts on the incidence of post liver transplant AKI.MethodsSingle-centre study of 1152 patients undergoing first-single-organ liver transplantation for chronic liver disease 01/2000-12/2011. To assess the impact of the evolution of graft quality over time; donor/graft/recipient variables were compared over three 4-year periods.ResultsPretransplant recipient renal function improved during follow-up (p <0.001), and the median postoperative day-1 (p <0.001), -2 (p <0.001), and -3 (p <0.001) tacrolimus trough levels fell. The proportion of patients receiving a higher risk graft was 31.8% in 2000-2003, 40.9% in 2004-2007, and 59.1% in 2008-2011 (p <0.001). There was a progressive increase in AKI (2000-2003, OR 1.00; 2004-2007, OR 1.43; 2008-2011, OR 2.40, p <0.001). After adjusting for recipient variables increasing recipient warm ischaemic time (p = 0.019), DCD transplantation (p <0.001), donor age ⩾60 years (p = 0.020), and donor body mass index ⩾30 kg/m2 (p <0.001) were independent predictors of AKI.ConclusionsThe increasing use of higher risk liver grafts is associated with an increased incidence of AKI. These findings support the need for therapies that minimise the hepatic ischaemia-reperfusion injury.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Hepatology - Volume 60, Issue 6, June 2014, Pages 1180-1186
نویسندگان
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