Can Pre–Liver Transplantation Renal Insufficiency Using a Creatinine Clearance Calculator Predict Long-Term Survival?

• Published in: Transplantation proceedings 2012-10, Vol.44 (8), p.2452-2454
• Main Authors: Boin, I.F.S.F, de Ataide, E.C, Dias, E.P.O, Stucchi, R.S.B, Seva-Pereira, T, Calomeni, G, Capel Junior, C.C, Mazzali, M
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Biological and medical sciences; Biomarkers - blood; Chi-Square Distribution; Creatinine - blood; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Kaplan-Meier Estimate; Kidney Function Tests; Liver Diseases - complications; Liver Diseases - mortality; Liver Diseases - surgery; Liver Transplantation - adverse effects; Liver Transplantation - mortality; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Proportional Hazards Models; Renal Insufficiency - blood; Renal Insufficiency - complications; Renal Insufficiency - diagnosis; Renal Insufficiency - mortality; Retrospective Studies; Risk Assessment; Risk Factors; ROC Curve; Severity of Illness Index; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate; Time Factors; Tissue, organ and graft immunology; Treatment Outcome
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.07.028

Abstract Introduction Renal insufficiency can be associated with poor long-term survival of liver transplant recipients. Objective The objective of this study was to study renal insufficiency observed pretransplantation and its long-term impact after liver transplantation. Methods We analyzed retrospectively an electronic database collected prospectively including transplant records from June 1994 to October 2010 using piggyback venous reconstruction. The exclusion criteria were chronic kidney disease, acute hepatic failure, children up to 12 years of age, and retransplantations. Renal insufficiency was defined by the creatinine clearance (CCr) calculated using the Cockcroft-Gault method. Patients were distributed into 3 groups: CCr >90, between 90 and 60, and >60 mL/min/1.73 m2 . The survival rate was calculated using the Kaplan-Meier method and proportional hazards Cox regression analysis using death and CCr as stratifying variables evaluated predictive factors for survival. The groups were compared using the Kruskal-Wallis test with significant differences at P < .05. Results Among the 305 patients those who showed preoperative and postoperative CCR of >90 were 187/59.9% and 82/26.3%, 60 to 90 were 77/24.7% and 74/23.7%, or