Value of MELD-Na score for prediction of the incidence of acute kidney injury early after orthotopic liver transplantation using retrograde perfusion

Wei Guoqing; Cheng Yuan; Cai Qiucheng; Yang Fang; Jiang Yi

doi:10.3969/j.issn.1674-7445.2017.05.005

Volume 8 Issue 5

Sep. 2017

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Article Navigation > ORGAN TRANSPLANTATION > 2017 > 8(5): 360-364

Wei Guoqing, Cheng Yuan, Cai Qiucheng, et al. Value of MELD-Na score for prediction of the incidence of acute kidney injury early after orthotopic liver transplantation using retrograde perfusion[J]. ORGAN TRANSPLANTATION, 2017, 8(5): 360-364. doi: 10.3969/j.issn.1674-7445.2017.05.005

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Value of MELD-Na score for prediction of the incidence of acute kidney injury early after orthotopic liver transplantation using retrograde perfusion

doi: 10.3969/j.issn.1674-7445.2017.05.005

Department of Hepatobiliary Surgery, Fuzhou General Teaching Hospital, Fujian Medical University, Fuzhou 350025, China

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Corresponding author: Jiang Yi, Email: jiangyi8183@163.com
Received Date: 2017-06-30
Available Online: 2021-01-19
Publish Date: 2017-09-15

Abstract

Abstract

Objective To evaluate the value of preoperative model for end-stage liver disease combined with serum sodium (MELD-Na) score for the prediction of the incidence of acute kidney injury (AKI) early after liver transplantation. Methods Clinical data of 315 recipients undergoing orthotopic liver transplantation by retrograde inferior vena caval perfusion were retrospectively analyzed. According to preoperative MELD-Na score, all patients were divided into group A (MELD-Na score ≤ 10, n=115), group B (10<MELD-Na score ≤ 20, n=118) and group C (MELDNa score>20, n=82). Preoperative and intraoperative parameters of the recipients were statistically compared among three groups. Preoperative parameters included serum creatinine (Scr), blood urea nitrogen (BUN), albumin (Alb), total bilirubin (TB), prothrombin time-international normalized ratio (PT-INR), mean arterial pressure (MAP) and serum Na⁺, etc. Intraoperative parameters included operation time, vena caval occlusion time, hemorrhage volume, quantity of red blood cell infusion, quantity of plasma transfusion and total fluid infusion volume, etc. The incidence and staging of AKI early after liver transplantation in the recipients were statistically compared among three groups. Spearman's rank correlation analysis was performed to analyze the correlation between preoperative MELD-Na score and AKI staging. Results Preoperative BUN, Alb, TB, PT-INR, MAP and Na⁺ in the recipients significantly differed among three groups (all P < 0.05). Intraoperative vena caval occlusion time, hemorrhage volume, quantity of red blood cell infusion and quantity of plasma transfusion significantly differed among three groups (all P < 0.05). In 315 recipients undergoing liver transplantation, the incidence of AKI within postoperative 1 week was 64.8% (204/315), and 43% (49/115), 71% (84/118) and 87% (71/82) in group A, B and C. Statistical significance was identified among three groups (all P < 0.05). Spearman's rank correlation analysis revealed that preoperative MELD-Na score was positively correlated with AKI staging (r=0.442, P=0.000). Conclusions MELD-Na score not only acts as a parameter evaluating preoperative patients' conditions, but also serves as a pivotal parameter predicting postoperative incidence of AKI.
- Liver transplantation,
- Retrograde perfusion,
- Model for end-stage liver disease (MELD),
- Serum Na⁺,
- MELD-Na score,
- Postoperative complication,
- Acute kidney injury,
- Prediction,
- Serum creatinine,
- Blood urea nitrogen

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References

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Value of MELD-Na score for prediction of the incidence of acute kidney injury early after orthotopic liver transplantation using retrograde perfusion

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Value of MELD-Na score for prediction of the incidence of acute kidney injury early after orthotopic liver transplantation using retrograde perfusion

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