The effects of intraoperative cryoprecipitate transfusion on acute renal failure following orthotropic liver transplantation

• Published in: Hepatology international 2013-07, Vol.7 (3), p.901-909
• Main Authors: Liu, Shuang, Wang, Xiaoliang, Lu, Yuanshan, Li, Tao, Gong, Zijun, Sheng, Tao, Hu, Bin, Peng, Zhihai, Sun, Xing
• Format: Article
• Language: English
• Subjects: Colorectal Surgery; Hepatology; Medicine; Medicine & Public Health; Original; Original Article; Surgery
• ISSN: 1936-0533; 1936-0541
• DOI: 10.1007/s12072-013-9457-9

Purpose The definition of risk factors associated with acute renal failure (ARF) following orthotropic liver transplantation (OLT) is still controversial. Cryoprecipitate, which can supply fibrinogen and other coagulation factors, is widely used in OLT. However, the effects of intraoperative cryoprecipitate transfusion on ARF following OLT remain unclear. Methods In a series of 389 adult patients who received grafts from deceased donors and underwent their first OLT, the clinical correlation between intraoperative cryoprecipitate transfusion and ARF following OLT was retrospectively studied after adjusting for potential confounders. The distribution of ARF and the causes of death within the first year after OLT were also compared separately in patients with and without cryoprecipitate transfusion. Results The incidence of ARF in patients with cryoprecipitate transfusion was significantly higher than in patients without cryoprecipitate transfusion (15.9 vs. 7.8 %, p  = 0.012). A nonlinear relationship between intraoperative cryoprecipitate transfusion and ARF following OLT was observed. The risk of ARF increased with the cryoprecipitate transfusion level up to the turning point (16 U) (adjusted OR 1.1, 95 % CI 1.1–1.2; p