Risk factors of acute renal failure associated with liver transplantation during operation

Objective To study the risk factors of renal failure associated with liver transplantation (RFALT) during orthotopic liver transplantation(OLT).Methods 53 patients without renal disfunction undergoing OLT were studied.Blood samples were drawn for determination of creatinine and blood urea nitrogen during operation and after operation.Then they were divided into two groups according the standard of Rimola et al:patients with RFALT and patients without RFALT.Nine variables were recorded and analyzed with univarite analysis and stepwise logistic regression to identify the risk factors.Results 14 patients were diagnosed as RFALT a week after operation.Univarite analysis indicated that five variables,including duration of anhepatic phase,volume of intraoperative blood-loss,volume of intraoperation blood transfusion,low blood pressure and the concentration of norepinephrine had significant difference between two groups. The stepwise logistic regression analysis for 5 variables demonstrated that duration of anhepatic phase(≥60 min) was the independent risk factor of acute renal failure during OLT.Conclusion Duration of anhepatic phase≥60 min was the independent risk factor of acute renal failure during OLT.Shorten the duration of anhepatic phase,decrease the volume of intraoperation blood transfusion and increase infusion of renal in order to decrease RFALT.