Causes for early postoperative renal dysfunction in classic orthotopic liver transplantation without venoveno bypass

Objective To determine the causes for postoperative renal dysfunction(RD)during the first week after classic orthotopic liver transplantation(OLT)without veno-veno bypass(VVBP). Methods The clinical data of 48 consecutive adult patients receiving classic OLT without VVBP in our hospital were retrospectively analyzed.The patients were grouped based on the level of serum creati- nine during the 1st week after OLT.The data that were statistically significant in univariate analysis were verified by multivariate analysis using binary logistic regression.Results The incidence of early postoperative RD after classic OLT without VVBP was 35.4%.The binary logistic regression analysis showed that preoperative renal dysfunction.Child-Pugh score,urine output during the anhepatic peri- od and the 1st h after removal of clamp on portal vein were significantly correlated to early postopera- tive RD.Conclusions The patients with the history of apparent RD or higher Child-Pugh score should undergo other types of OLT rather than OLT without VVBP.Maintaining stable hemodynamics and sufficient renal blood perfusion may decrease the incidence of early postoperative RD in the patients un- dergoing OLT without VVBP.