In the Journals

Live-donor allograft decreases risk of acute kidney injury post-liver transplant

Researchers from University of Pittsburgh Medical Center found that liver transplant recipients of a living donor liver allograft had reduced odds of acute kidney injury at 72 hours post-transplant, according to published findings.

Researcher Ibtesam A. Hilmi, MBCHB, FRCA, associate professor, department of anesthesiology, Presbyterian Hospital, University of Pittsburgh Medical Center, and colleagues retrospectively analyzed data of living donor liver transplant (LDLT; n = 100) and deceased donor liver transplant (DDLT; n = 424) recipients between January 2006 and December 2011 at University of Pittsburgh Medical Center. Recipients were included in a propensity score matching logistic model on the basis of age, sex, MELD score, Child-Pugh score, pre-transplant serum creatinine and pre-existing diabetes mellitus. Eighty-six pairs were created after 1-to-1 propensity matching, according to the research.

Ibtesam A. Hilmi

“Both groups included adults with end-stage liver disease who received either right lobe partial liver allografts from living donors or full livers from deceased donors,” Hilmi told Healio.com/Hepatology. “Patients with fulminant liver failure or a history of previous liver transplant, patients with chronic renal failure on dialysis, and patients who died within the first 72 hours after liver transplant were excluded.”

Overall, 21% of LDLT recipients developed acute kidney injury (AKI) within the first 72 hours after transplant compared with the DDLT recipients who had an AKI incidence rate of 52.1% within 72 hours post-transplant (P < .001).

Multivariate logistic analysis showed that developing post-reperfusion syndrome was associated with developing AKI within 72 hours after liver transplant (P = .014). A full multivariate model showed that liver graft type was the only variable associated with AKI at 72 hours after transplant.

After using the propensity score matching system, the LDLT recipients’ incidence rate of AKI at 72 hours after transplant was 23.3% compared with the DDLT recipients’ rate of 44.2% (P = .004).

One-year mortality rates after propensity score matching were not statistically different between the groups, as well as recipients’ 1-year survival rates based on the type of liver graft after matching.

“The incidence of post-transplant AKI in living liver donor transplant recipients was much lower than the incidence in the corresponding matched-control group of deceased donor liver transplant recipients,” Hilmi said. “In short, receiving a graft from a living donor had a protective effect against early post-[transplant] AKI.”

Disclosures: The researchers report no relevant financial disclosures. 

Researchers from University of Pittsburgh Medical Center found that liver transplant recipients of a living donor liver allograft had reduced odds of acute kidney injury at 72 hours post-transplant, according to published findings.

Researcher Ibtesam A. Hilmi, MBCHB, FRCA, associate professor, department of anesthesiology, Presbyterian Hospital, University of Pittsburgh Medical Center, and colleagues retrospectively analyzed data of living donor liver transplant (LDLT; n = 100) and deceased donor liver transplant (DDLT; n = 424) recipients between January 2006 and December 2011 at University of Pittsburgh Medical Center. Recipients were included in a propensity score matching logistic model on the basis of age, sex, MELD score, Child-Pugh score, pre-transplant serum creatinine and pre-existing diabetes mellitus. Eighty-six pairs were created after 1-to-1 propensity matching, according to the research.

Ibtesam A. Hilmi

“Both groups included adults with end-stage liver disease who received either right lobe partial liver allografts from living donors or full livers from deceased donors,” Hilmi told Healio.com/Hepatology. “Patients with fulminant liver failure or a history of previous liver transplant, patients with chronic renal failure on dialysis, and patients who died within the first 72 hours after liver transplant were excluded.”

Overall, 21% of LDLT recipients developed acute kidney injury (AKI) within the first 72 hours after transplant compared with the DDLT recipients who had an AKI incidence rate of 52.1% within 72 hours post-transplant (P < .001).

Multivariate logistic analysis showed that developing post-reperfusion syndrome was associated with developing AKI within 72 hours after liver transplant (P = .014). A full multivariate model showed that liver graft type was the only variable associated with AKI at 72 hours after transplant.

After using the propensity score matching system, the LDLT recipients’ incidence rate of AKI at 72 hours after transplant was 23.3% compared with the DDLT recipients’ rate of 44.2% (P = .004).

One-year mortality rates after propensity score matching were not statistically different between the groups, as well as recipients’ 1-year survival rates based on the type of liver graft after matching.

“The incidence of post-transplant AKI in living liver donor transplant recipients was much lower than the incidence in the corresponding matched-control group of deceased donor liver transplant recipients,” Hilmi said. “In short, receiving a graft from a living donor had a protective effect against early post-[transplant] AKI.”

Disclosures: The researchers report no relevant financial disclosures.