Volume 13 Issue 2
Mar.  2022
Turn off MathJax
Article Contents
Article Navigation >  ORGAN TRANSPLANTATION  > 2022  >  13(2): 219-224
Chen Chen, Yang Run, Feng Junqi, et al. Relationship between the incidence of acute kidney injury and postoperative changes of coagulation function in adult recipients after liver transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(2): 219-224. doi: 10.3969/j.issn.1674-7445.2022.02.010
Citation: Chen Chen, Yang Run, Feng Junqi, et al. Relationship between the incidence of acute kidney injury and postoperative changes of coagulation function in adult recipients after liver transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(2): 219-224. doi: 10.3969/j.issn.1674-7445.2022.02.010
shu

Relationship between the incidence of acute kidney injury and postoperative changes of coagulation function in adult recipients after liver transplantation

doi: 10.3969/j.issn.1674-7445.2022.02.010

  • Department of Critical Medicine, Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai 200127, China

More Information
  • Corresponding author: Deng Yuxiao, Email: denyuxiao@renji.com
  • Received Date: 2021-11-25
    Available Online: 2022-03-18
  • Publish Date: 2022-03-15
    Abstract
  •   Objective  To evaluate the effect of coagulation function changes on the incidence of acute kidney injury (AKI) after liver transplantation.  Methods  Clinical data of 245 liver transplant recipients who met the inclusion and exclusion criteria were retrospectively analyzed. According to the incidence of AKI after liver transplantation, all recipients were divided into the AKI group (n=99) and non-AKI group (n=146). The incidence of AKI after liver transplantation was summarized. Perioperative parameters of the recipients were collected. The risk factors of AKI after liver transplantation were assessed by univariate and multivariate analysis.  Results  Among 245 recipients undergoing liver transplantation, 99 cases developed AKI after operation with an incidence rate of 40.4%. Preoperative serum creatinine levels of the recipients and the in-hospital fatality were relatively high in the AKI group (all P < 0.05). Compared with the recipients in the non-AKI group, those in the AKI group presented with significantly higher liver function parameters within postoperative 24 h, significantly decreased levels of stage Ⅱ coagulation parameters including coagulation factorsⅤ, Ⅶ, Ⅸ, Ⅹ, Ⅻ and protein S, protein C and antithrombin Ⅲ, evidently elevated prothrombin time international normalized ratio (PT-INR), remarkably increased stage Ⅲ coagulation parameters including D-dimer and fibrin degradation product (FDP) levels and considerably decreased fibrinogen (FIB) level (all P < 0.05). Thrombelastogram showed that the R value was increased, the α angle was decreased and the coagulation time was prolonged in the AKI group (all P < 0.05). Logistic regression analysis demonstrated that the increased R value of postoperative thrombelastogram [odd ratio (OR) 1.116, 95% confidence interval (CI) 1.018-1.223, P=0.019], and decreased levels of antithrombin Ⅲ (OR 0.974, 95%CI 0.955-0.993, P=0.007) were the independent risk factors of incidence of AKI after liver transplantation.  Conclusions  The incidence of AKI after liver transplantation is high, which is associated with the coagulation function changes of the recipients. Decreased coagulation factor activity (increased R value) and declined antithrombin Ⅲ level are the independent risk factors of AKI in liver transplantat recipients.

     

    • FullText(HTML)
  • loading
    • References(28)
  • [1]
    LEVEY AS, JAMES MT. Acute kidney injury[J]. Ann Intern Med, 2017, 167(9): ITC66-ITC80. DOI: 10.7326/AITC201711070.
    [2]
    YEUNG ACY, MOROZOV A, ROBERTSON FP, et al. Neutrophil gelatinase-associated lipocalin (NGAL) in predicting acute kidney injury following orthotopic liver transplantation: a systematic review[J]. Int J Surg, 2018, 59: 48-54. DOI: 10.1016/j.ijsu.2018.09.003.
    [3]
    ZHOU J, ZHANG X, LYU L, et al. Modifiable risk factors of acute kidney injury after liver transplantation: a systematic review and Meta-analysis[J]. BMC Nephrol, 2021, 22(1): 149. DOI: 10.1186/s12882-021-02360-8.
    [4]
    王延庆, 韩玉珍, 张进, 等. 肝移植术后血清肌红蛋白水平对患者新发急性肾损伤的预测价值[J]. 实用医学杂志, 2021, 37(1): 46-50. DOI: 10.3969/j.issn.1006-5725.2021.01.010.

    WANG YQ, HAN YZ, ZHANG J, et al. The predictive value of serum myoglobin level with the occurrence of acute renal injury in liver transplantation patients[J]. J Pract Med, 2021, 37(1): 46-50. DOI: 10.3969/j.issn.1006-5725.2021.01.010.
    [5]
    TAN L, YANG Y, MA G, et al. Early acute kidney injury after liver transplantation in patients with normal preoperative renal function[J]. Clin Res Hepatol Gastroenterol, 2019, 43(4): 475-482. DOI: 10.1016/j.clinre.2018.07.009.
    [6]
    CHENG Y, WEI GQ, CAI QC, et al. Prognostic value of model for end-stage liver disease incorporating with serum sodium score for development of acute kidney injury after liver transplantation[J]. Chin Med J (Engl), 2018, 131(11): 1314-1320. DOI: 10.4103/0366-6999.232798.
    [7]
    YU JH, KWON Y, KIM J, et al. Influence of transfusion on the risk of acute kidney injury: ABO-compatible versus ABO-incompatible liver transplantation[J]. J Clin Med, 2019, 8(11): 1785. DOI: 10.3390/jcm8111785.
    [8]
    李喆, 尚晨, 张志贇, 等. 成人肝移植术后早期急性肾损伤的发生和危险因素分析[J]. 武汉大学学报(医学版), 2020, 41(3): 485-489. DOI: 10.14188/j.1671-8852.2019.0812.

    LI Z, SHANG C, ZHANG ZY, et al. Investigation of incidence and risk factors of early acute kidney injury in adults after orthotopic liver transplantation[J]. Med J Wuhan Univ, 2020, 41(3): 485-489. DOI: 10.14188/j.1671-8852.2019.0812.
    [9]
    SATO Y, YANAGITA M. Immune cells and inflammation in AKI to CKD progression[J]. Am J Physiol Renal Physiol, 2018, 315(6): F1501-F1512. DOI: 10.1152/ajprenal.00195.2018.
    [10]
    CHEN G, LIU B, LI H, et al. Ethnicity-stratified analysis of the association between TNF-α genetic polymorphisms and acute kidney injury: a systematic review and Meta-analysis[J]. Biomed Res Int, 2020: 5262351. DOI: 10.1155/2020/5262351.
    [11]
    THONGPRAYOON C, KAEWPUT W, THAMCHAROEN N, et al. Incidence and impact of acute kidney injury after liver transplantation: a Meta-analysis[J]. J Clin Med, 2019, 8(3): 372. DOI: 10.3390/jcm8030372.
    [12]
    FELDKAMP T, BIENHOLZ A, PAUL A, et al. Renal damage after liver transplantation[J]. Biosci Rep, 2020, 40(1): BSR20191187. DOI: 10.1042/BSR20191187.
    [13]
    KOLLMANN D, NEONG SF, ROSALES R, et al. Renal dysfunction after liver transplantation: effect of donor type[J]. Liver Transpl, 2020, 26(6): 799-810. DOI: 10.1002/lt.25755.
    [14]
    FABRIZI F, DONATO MF, CERUTTI R, et al. Acute kidney injury and chronic kidney disease after liver transplant: a retrospective observational study[J]. Nefrologia (Engl Ed), 2021, DOI: 10.1016/j.nefro.2021.01.009 [Epub ahead of print].
    [15]
    BELLOMO R, RONCO C, KELLUM JA, et al. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the Acute Dialysis Quality Initiative (ADQI) Group[J]. Crit Care, 2004, 8(4): R204-R212. DOI: 10.1186/cc2872.
    [16]
    MEHTA RL, KELLUM JA, SHAH SV, et al. Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury[J]. Crit Care, 2007, 11(2): R31. DOI: 10.1186/cc5713.
    [17]
    KHWAJA A. KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron Clin Pract, 2012, 120(4): c179-c184. DOI: 10.1159/000339789.
    [18]
    MENON S, POLLACK AH, SULLIVAN E, et al. Acute kidney injury and chronic kidney disease after non-kidney solid organ transplantation[J]. Pediatr Transplant, 2020, 24(6): e13753. DOI: 10.1111/petr.13753.
    [19]
    韩悦, 郭书琰, 韩玉珍, 等. 肝移植术后早期与晚期急性肾损伤的危险因素[J]. 中国急救医学, 2021, 41(3): 201-205. DOI: 10.3969/j.issn.1002-1949.2021.03.004.

    HAN Y, GUO SY, HAN YZ, et al. Analysis of risk factors for early and late acute kidney injury after liver transplantation[J]. Chin J Crit Care Med, 2021, 41(3): 201-205. DOI: 10.3969/j.issn.1002-1949.2021.03.004.
    [20]
    DE HAAN JE, HOORN EJ, DE GEUS HRH. Acute kidney injury after liver transplantation: recent insights and future perspectives[J]. Best Pract Res Clin Gastroenterol, 2017, 31(2): 161-169. DOI: 10.1016/j.bpg.2017.03.004.
    [21]
    JOCHMANS I, MEURISSE N, NEYRINCK A, et al. Hepatic ischemia/reperfusion injury associates with acute kidney injury in liver transplantation: prospective cohort study[J]. Liver Transpl, 2017, 23(5): 634-644. DOI: 10.1002/lt.24728.
    [22]
    RAHMAN S, DAVIDSON BR, MALLETT SV. Early acute kidney injury after liver transplantation: predisposing factors and clinical implications[J]. World J Hepatol, 2017, 9(18): 823-832. DOI: 10.4254/wjh.v9.i18.823.
    [23]
    KALISVAART M, DE HAAN JE, HESSELINK DA, et al. The postreperfusion syndrome is associated with acute kidney injury following donation after brain death liver transplantation[J]. Transpl Int, 2017, 30(7): 660-669. DOI: 10.1111/tri.12891.
    [24]
    DURAND F, FRANCOZ C, ASRANI SK, et al. Acute kidney injury after liver transplantation[J]. Transplantation, 2018, 102(10): 1636-1649. DOI: 10.1097/TP.0000000000002305.
    [25]
    VAN GOLEN RF, REINIERS MJ, VRISEKOOP N, et al. The mechanisms and physiological relevance of glycocalyx degradation in hepatic ischemia/reperfusion injury[J]. Antioxid Redox Signal, 2014, 21(7): 1098-1118. DOI: 10.1089/ars.2013.5751.
    [26]
    ZANETTO A, RINDER HM, CAMPELLO E, et al. Acute kidney injury in decompensated cirrhosis is associated with both hypo-coagulable and hyper-coagulable features[J]. Hepatology, 2020, 72(4): 1327-1340. DOI: 10.1002/hep.31443.
    [27]
    THAI C, OBEN C, WAGENER G. Coagulation, hemostasis, and transfusion during liver transplantation[J]. Best Pract Res Clin Anaesthesiol, 2020, 34(1): 79-87. DOI: 10.1016/j.bpa.2020.03.002.
    [28]
    CHERIAN TP, CHIU K, GUNSON B, et al. Pulmonary thromboembolism in liver transplantation: a retrospective review of the first 25 years[J]. Transpl Int, 2010, 23(11): 1113-1119. DOI: 10.1111/j.1432-2277.2010.01105.x.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (276) PDF downloads(87) Cited by()
    Proportional views
    Related

    WeChat Subscription Account

    Wechat Service Account

    Contact Us
    • Tel：020-38736410
    • Email: organtranspl@163.com
    • Address：The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou
    • Editorial Office of Organ Transplantation  粤ICP备2021030844号
    Links

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return