An effective model for predicting acute kidney injury after liver transplantation

摘要

BACKGROUND: Acute kidney injury (AKI) is a common complication in the early period after liver transplantation (LT), posing an enormous obstacle to treatment efifciency and patient survival. However, the exact inlfuencing factors of AKI are still unclear and a predictive model is desperately required in the clinic. METHODS: Data of 102 consecutive LTs were reviewed. A model for predicting AKI was established and further validated in a prospective study of 44 patients receiving LT. RESULTS: The incidence of AKI was 32.4%. AKI patients showed a signiifcantly lower survival rate than non-AKI patients. Multivariate analysis demonstrated the independent inlfuencing factors of AKI were preoperative serum creatinine>1.2 mg/dl, intraoperative urine output≤60 ml/h, intraoperative hypotension status, and intraoperative use of noradrenaline. A model was then established and showed a sensitivity of 75.0%, a speciifcity of 93.8%, and an accuracy of 88.6%in predicting AKI. CONCLUSIONS: High preoperative serum creatinine, low intraoperative urine output, and intraoperative hypotension contribute to the development of AKI, and intraoperative use of noradrenaline serves as a protective factor. The predictive model could potentially facilitate early prediction and surveillance of AKI.