Hepatic ischemia reperfusion injury is associated with acute kidney injury following donation after brain death liver transplantation

Joanna A Leithead, Matthew J Armstrong, Christopher Corbett, Mark Andrew, Chirag Kothari, Bridget K Gunson, Paolo Muiesan, James W Ferguson

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)

Abstract

Donation after cardiac death liver transplant recipients have an increased frequency of acute kidney injury (AKI). This suggests that hepatic ischemia-reperfusion injury may play a critical role in the pathogenesis of AKI after liver transplantation. The aim of this single-center study was to determine if hepatic ischemia-reperfusion injury, estimated by peak peri-operative serum amino-transferase (AST), is associated with AKI following donation after brain death (DBD) liver transplantation. A total of 296 patients received 298 DBD liver transplants from January 2007 to June 2011. The incidence of AKI was 35.9%. AKI was a risk factor for chronic kidney disease (P = 0.037) and mortality (P = 0.002). On univariate analysis, peak AST correlated with peak creatinine (P < 0.001) and peak change in creatinine from baseline (P < 0.001). Peak AST was higher in AKI patients (P < 0.001). The incidence of AKI in patients with a peak AST of <1500, 1500-2999 and ≥ 3000 U/l was 26.1%, 39.8% and 71.2%, respectively (P < 0.001). On multiple logistic regression analysis, peak AST was independently associated with the development of AKI (P < 0.001). In conclusion, hepatic ischemia-reperfusion injury demonstrates a strong relationship with peri-operative AKI in DBD liver transplant recipients.

Original languageEnglish
Pages (from-to)1116-25
Number of pages10
JournalTransplant international
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Acute Kidney Injury
  • Adult
  • Aspartate Aminotransferases
  • Brain Death
  • Female
  • Humans
  • Kidney
  • Liver
  • Liver Transplantation
  • Male
  • Middle Aged
  • Perioperative Period
  • Reperfusion Injury

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