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Risk factors of acute kidney injury after orthotopic liver transplantation in China

机译:中国原位肝移植术后急性肾损伤的危险因素

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摘要

In this study, we determined the risk factors for acute kidney injury (AKI) following orthotopic liver transplantation (OLT) in China. We collected 5074 donation after cardiac death (DCD) OLT recipients who underwent surgery between January 1, 2010, and December 31, 2015, in 86 academic hospitals or transplant centers in China. Univariate and multivariate analyses were used to investigate the criticality of donor, graft, or recipient variables in the development of post-OLT AKI. In all, 4482 patients were included (median age, 49.31 years). Post-OLT AKI occurred in 3.97% patients, and 73.6% of all OLT patients were male. The 1- and 5-year cumulative survival rates (CSRs) of the AKI group were 33.95% and 25.24%, respectively, compared with 86.34% and 70.05%, respectively, of the non-AKI group (P < 0.001). The independent risk factors for post-OLT AKI were blood loss, cold ischemia time, warm ischemia time, preoperative serum creatinine, the treatment period with dopamine, overexposure to calcineurin inhibitor, and combined mycophenolate mofetil use (P < 0.05). These had a high prediction accuracy for post-OLT AKI (area under the curve [AUC] = 0.740).
机译:在这项研究中,我们确定了中国原位肝移植(OLT)后发生急性肾损伤(AKI)的危险因素。我们收集了2010年1月1日至2015年12月31日期间接受手术的5074名心脏死亡(DCD)OLT接受者的捐赠,这些捐赠在中国的86家学术医院或移植中心中进行。使用单变量和多变量分析来研究供体,移植物或受体变量在OLT后AKI发生中的重要性。总共包括4482例患者(中位年龄为49.31岁)。 OLT后AKI发生在3.97%的患者中,所有OLT患者中的73.6%是男性。 AKI组的1年和5年累积生存率(CSR)分别为33.95%和25.24%,而非AKI组分别为86.34%和70.05%(P <0.001)。 OLT后AKI的独立危险因素为失血,冷缺血时间,温暖缺血时间,术前血清肌酐,多巴胺治疗期,钙调神经磷酸酶抑制剂过度暴露以及联用霉酚酸酯(P <0.05)。这些对于OLT后AKI具有很高的预测精度(曲线下面积[AUC] = 0.740)。

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