Korean J Nephrol.  2002 Jan;21(1):145-151.

Clinical Features and Effects on Prognosis of ARF that Occurred after Liver Transplantation

• Kim KS
• Lee SG
• Kim SG
• Oh YK
• Kim YS
• Suh KS
• Ahn CR
• Han JS
• Kim SG
• Lee JS

Abstract

BACKGROUND: One of the major complications of liver transplantation is acute renal failure(ARF). The outcome in patients who develop postoperative renal failure has been dismal. But there are few reports on ARF after liver transplantation in Korea. The aim of this study was to determine the incidence, clinical characteristics, and prognosis of ARF in patients undergoing liver transplantation.
METHODS
The records of 35 adult patients who received liver transplantation at the Seoul National University Hospital between october 1992 and June 2001 were reviewed retrospectively.
RESULTS
22 patients were male and 13 were female, with an age range of 15 years to 65 years(median, 49 years). The 35 recipients included 18 with liver cirrhosis, 10 with liver cirrhosis and hepatoma, 3 with hepatoma, 3 with fulminant hepatitis, and 1 with biliary atresia. Death occurred in 10 patients (29%) overall. ARF was developed in 25 cases(71%), and 8 cases(32%) expired. Among the 9 patients with peak serum creatinine level > or = 2.0 mg/dL, 7 patients expired. 2 patients required hemodialysis following liver transplantation and all of them expired. ARF was developed within 1day(0-39 days). Of 25 ARF cases, 21 cases of hypotension, 6 acute rejection, 10 spontaneous bacterial peritonitis(SBP), and 8 massive packed RBC transfusion were associated. Renal function at latest follow-up was improved in patients who were suffered with ARF.
CONCLUSION
ARF is a frequent complication of liver transplantation, and the strategy of management and prevention of ARF needs to be developed.

Keyword

Liver transplantation; Acute renal failure

MeSH Terms

Acute Kidney Injury
Adult
Biliary Atresia
Carcinoma, Hepatocellular
Creatinine
Female
Follow-Up Studies
Hepatitis
Humans
Hypotension
Incidence
Korea
Liver Cirrhosis
Liver Transplantation*
Liver*
Male
Prognosis*
Renal Dialysis
Renal Insufficiency
Retrospective Studies
Seoul
Creatinine