Risk factors for early acute renal failure after liver transplantation

Objective To detect risk factors for early acute renal failure(ARF)after orthotopic liver transplantation(OLT).Methods189patients who underwent liver transplantation in our center were analyzed retrospectively. They were divided into ARF and non-ARF groups according to serum creatinine level early after OLT. Peri-operative clinical and laboratory variables of these two groups were compared with univariate analysis,and then variables with significantly statistic difference were further studied with logistic regression analysis.Results68(36.0%)of the189patients develop post-OLT early ARF. Age,body mass index(BMI),pre-OLT serum creatinine, model for end-stage liver disease(MELD)score,minimum mean arterial pressure during operation,low blood pressure duration, blood products transfusion volume, urine output during operation were significantly different between these two groups with univariate analysis( all P0. 05). Logistic regression analysis showed low blood pressure time during operation and urine output were independent risk factors for development of early ARF after OLT( both P0. 05). In patients with early ARF, the duration of mechanical ventilation was prolonged, length of stay in the transplant intensive care unit( TICU) was longer than that in non-ARF group( both P0. 05). Conclusions Patients with early ARF had prolonged duration of mechanical ventilation and longer stay in TICU. Low blood pressure during operation and urine output are independent risk factors for development of early ARF after OLT.