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Association of post‐reperfusion syndrome and ischemia‐reperfusion injury with acute kidney injury after liver transplantation
Background Acute kidney injury (AKI) is frequently observed after orthotopic liver transplantation (OLT) even in patients with previously normal renal function. In this study, we investigated the impact of factors such graft steatosis, post‐reperfusion syndrome (PRS), and hepatic ischemia reperfusio...
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| Published in: | Acta anaesthesiologica Scandinavica 2020-07, Vol.64 (6), p.742-750 |
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| container_title | Acta anaesthesiologica Scandinavica |
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| creator | Tokodai, Kazuaki Lannsjö, Claudia Kjaernet, Felicia Romano, Antonio Januszkiewicz, Anna Ericzon, Bo‐Göran Nowak, Greg |
| description | Background
Acute kidney injury (AKI) is frequently observed after orthotopic liver transplantation (OLT) even in patients with previously normal renal function. In this study, we investigated the impact of factors such graft steatosis, post‐reperfusion syndrome (PRS), and hepatic ischemia reperfusion injury (HIRI) on the development of AKI after OLT in adult patients.
Methods
We retrospectively examined consecutive adult patients who underwent OLT at our institution between July 2011 and June 2017. AKI was diagnosed based on the criteria proposed by the International Kidney Disease Improving Global Outcomes (KDIGO) workgroup. Peak aspartate aminotransferase (AST) level within 72 hours after OLT was used as a surrogate marker for HIRI. Graft steatosis was diagnosed by histopathological examination using specimens biopsied intraoperatively at the end of transplantation procedure and categorized as |
| doi_str_mv | 10.1111/aas.13556 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_473751</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2351486514</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4766-549fc2c756a90cf998400d874988ed78082f0749fbe57830f3633c4cbc54865f3</originalsourceid><addsrcrecordid>eNp1ks1u3CAUhVHVqplOu-gLVJa6aRdOwICB5SjqnxSpi7ZrxGBQmNjGBTsj79o36DP2SXonnkmlSGEBXPjOAS4XodcEnxNoF8bkc0I5r5-gFaFKlTUX9VO0whiTkhNRnaEXOe8gpEyp5-iMVrjCXMoV-r3JOdpgxhD7IvpiiHn8--tPcoNLfsqH1Tz3TYqdK0zfFCHba9cF84AJ_W5Kc7EP43Vh7DS64iY0vZtPG8aPLhVtuIV-TKbPQ2v68e7Ul-iZN212r47jGv34-OH75efy6uunL5ebq9IyUdclZ8rbygpeG4WtV0oyjBspmJLSNUJiWXkMkd86LiTFntaUWma3ljNZc0_XqFx8894N01YPKXQmzTqaoI9LNzBzmgkqOAFePcoPKTb_RSchYRQSLBUF7btFC-DPyeVRd5A418KjXZyyrignh1uBYo3ePkB3cUo9ZEJXjBAFllIC9X6hbIo5J-fvr0OwPtSAhhrQdzUA7Juj47TtXHNPnj4dgIsF2IfWzY876c3m22L5D-xHwFY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2411930388</pqid></control><display><type>article</type><title>Association of post‐reperfusion syndrome and ischemia‐reperfusion injury with acute kidney injury after liver transplantation</title><source>Wiley</source><creator>Tokodai, Kazuaki ; Lannsjö, Claudia ; Kjaernet, Felicia ; Romano, Antonio ; Januszkiewicz, Anna ; Ericzon, Bo‐Göran ; Nowak, Greg</creator><creatorcontrib>Tokodai, Kazuaki ; Lannsjö, Claudia ; Kjaernet, Felicia ; Romano, Antonio ; Januszkiewicz, Anna ; Ericzon, Bo‐Göran ; Nowak, Greg</creatorcontrib><description>Background
Acute kidney injury (AKI) is frequently observed after orthotopic liver transplantation (OLT) even in patients with previously normal renal function. In this study, we investigated the impact of factors such graft steatosis, post‐reperfusion syndrome (PRS), and hepatic ischemia reperfusion injury (HIRI) on the development of AKI after OLT in adult patients.
Methods
We retrospectively examined consecutive adult patients who underwent OLT at our institution between July 2011 and June 2017. AKI was diagnosed based on the criteria proposed by the International Kidney Disease Improving Global Outcomes (KDIGO) workgroup. Peak aspartate aminotransferase (AST) level within 72 hours after OLT was used as a surrogate marker for HIRI. Graft steatosis was diagnosed by histopathological examination using specimens biopsied intraoperatively at the end of transplantation procedure and categorized as <10%, 10%‐20%, 20%‐30%, and ≥30% of hepatic steatosis.
Results
Out of 386 patients, 141 (37%) developed AKI (KDIGO stage 1:71 patients; stage 2:29 patients; stage 3:41 patients). Multivariable logistic regression analysis revealed that cold ischemic time (P = .012) and HIRI (P = .007) were independent risk factors for post‐OLT AKI. Multivariable analysis also revealed that graft steatosis was associated with HIRI but not directly with AKI. PRS was not associated with HIRI or AKI in the multivariable analyses.
Conclusion
Our results indicate that greater severity of liver graft injury during transplantation negatively affects renal function after OLT. As expected, the severity of liver graft steatosis contributes to accelerated liver injury occurring during the transplantation procedure.</description><identifier>ISSN: 0001-5172</identifier><identifier>ISSN: 1399-6576</identifier><identifier>EISSN: 1399-6576</identifier><identifier>DOI: 10.1111/aas.13556</identifier><identifier>PMID: 32020588</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aspartate aminotransferase ; Fatty liver ; Grafting ; Injuries ; Ischemia ; Kidney diseases ; Kidney transplantation ; Kidneys ; Liver ; Liver transplantation ; Medicin och hälsovetenskap ; Regression analysis ; Renal function ; Reperfusion ; Risk analysis ; Risk factors ; Steatosis ; Transplantation</subject><ispartof>Acta anaesthesiologica Scandinavica, 2020-07, Vol.64 (6), p.742-750</ispartof><rights>2020 The Authors. published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation</rights><rights>2020 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4766-549fc2c756a90cf998400d874988ed78082f0749fbe57830f3633c4cbc54865f3</citedby><cites>FETCH-LOGICAL-c4766-549fc2c756a90cf998400d874988ed78082f0749fbe57830f3633c4cbc54865f3</cites><orcidid>0000-0002-0607-8250</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32020588$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:143034893$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Tokodai, Kazuaki</creatorcontrib><creatorcontrib>Lannsjö, Claudia</creatorcontrib><creatorcontrib>Kjaernet, Felicia</creatorcontrib><creatorcontrib>Romano, Antonio</creatorcontrib><creatorcontrib>Januszkiewicz, Anna</creatorcontrib><creatorcontrib>Ericzon, Bo‐Göran</creatorcontrib><creatorcontrib>Nowak, Greg</creatorcontrib><title>Association of post‐reperfusion syndrome and ischemia‐reperfusion injury with acute kidney injury after liver transplantation</title><title>Acta anaesthesiologica Scandinavica</title><addtitle>Acta Anaesthesiol Scand</addtitle><description>Background
Acute kidney injury (AKI) is frequently observed after orthotopic liver transplantation (OLT) even in patients with previously normal renal function. In this study, we investigated the impact of factors such graft steatosis, post‐reperfusion syndrome (PRS), and hepatic ischemia reperfusion injury (HIRI) on the development of AKI after OLT in adult patients.
Methods
We retrospectively examined consecutive adult patients who underwent OLT at our institution between July 2011 and June 2017. AKI was diagnosed based on the criteria proposed by the International Kidney Disease Improving Global Outcomes (KDIGO) workgroup. Peak aspartate aminotransferase (AST) level within 72 hours after OLT was used as a surrogate marker for HIRI. Graft steatosis was diagnosed by histopathological examination using specimens biopsied intraoperatively at the end of transplantation procedure and categorized as <10%, 10%‐20%, 20%‐30%, and ≥30% of hepatic steatosis.
Results
Out of 386 patients, 141 (37%) developed AKI (KDIGO stage 1:71 patients; stage 2:29 patients; stage 3:41 patients). Multivariable logistic regression analysis revealed that cold ischemic time (P = .012) and HIRI (P = .007) were independent risk factors for post‐OLT AKI. Multivariable analysis also revealed that graft steatosis was associated with HIRI but not directly with AKI. PRS was not associated with HIRI or AKI in the multivariable analyses.
Conclusion
Our results indicate that greater severity of liver graft injury during transplantation negatively affects renal function after OLT. As expected, the severity of liver graft steatosis contributes to accelerated liver injury occurring during the transplantation procedure.</description><subject>Aspartate aminotransferase</subject><subject>Fatty liver</subject><subject>Grafting</subject><subject>Injuries</subject><subject>Ischemia</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Kidneys</subject><subject>Liver</subject><subject>Liver transplantation</subject><subject>Medicin och hälsovetenskap</subject><subject>Regression analysis</subject><subject>Renal function</subject><subject>Reperfusion</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Steatosis</subject><subject>Transplantation</subject><issn>0001-5172</issn><issn>1399-6576</issn><issn>1399-6576</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1ks1u3CAUhVHVqplOu-gLVJa6aRdOwICB5SjqnxSpi7ZrxGBQmNjGBTsj79o36DP2SXonnkmlSGEBXPjOAS4XodcEnxNoF8bkc0I5r5-gFaFKlTUX9VO0whiTkhNRnaEXOe8gpEyp5-iMVrjCXMoV-r3JOdpgxhD7IvpiiHn8--tPcoNLfsqH1Tz3TYqdK0zfFCHba9cF84AJ_W5Kc7EP43Vh7DS64iY0vZtPG8aPLhVtuIV-TKbPQ2v68e7Ul-iZN212r47jGv34-OH75efy6uunL5ebq9IyUdclZ8rbygpeG4WtV0oyjBspmJLSNUJiWXkMkd86LiTFntaUWma3ljNZc0_XqFx8894N01YPKXQmzTqaoI9LNzBzmgkqOAFePcoPKTb_RSchYRQSLBUF7btFC-DPyeVRd5A418KjXZyyrignh1uBYo3ePkB3cUo9ZEJXjBAFllIC9X6hbIo5J-fvr0OwPtSAhhrQdzUA7Juj47TtXHNPnj4dgIsF2IfWzY876c3m22L5D-xHwFY</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Tokodai, Kazuaki</creator><creator>Lannsjö, Claudia</creator><creator>Kjaernet, Felicia</creator><creator>Romano, Antonio</creator><creator>Januszkiewicz, Anna</creator><creator>Ericzon, Bo‐Göran</creator><creator>Nowak, Greg</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-0607-8250</orcidid></search><sort><creationdate>202007</creationdate><title>Association of post‐reperfusion syndrome and ischemia‐reperfusion injury with acute kidney injury after liver transplantation</title><author>Tokodai, Kazuaki ; Lannsjö, Claudia ; Kjaernet, Felicia ; Romano, Antonio ; Januszkiewicz, Anna ; Ericzon, Bo‐Göran ; Nowak, Greg</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4766-549fc2c756a90cf998400d874988ed78082f0749fbe57830f3633c4cbc54865f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aspartate aminotransferase</topic><topic>Fatty liver</topic><topic>Grafting</topic><topic>Injuries</topic><topic>Ischemia</topic><topic>Kidney diseases</topic><topic>Kidney transplantation</topic><topic>Kidneys</topic><topic>Liver</topic><topic>Liver transplantation</topic><topic>Medicin och hälsovetenskap</topic><topic>Regression analysis</topic><topic>Renal function</topic><topic>Reperfusion</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Steatosis</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tokodai, Kazuaki</creatorcontrib><creatorcontrib>Lannsjö, Claudia</creatorcontrib><creatorcontrib>Kjaernet, Felicia</creatorcontrib><creatorcontrib>Romano, Antonio</creatorcontrib><creatorcontrib>Januszkiewicz, Anna</creatorcontrib><creatorcontrib>Ericzon, Bo‐Göran</creatorcontrib><creatorcontrib>Nowak, Greg</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Acta anaesthesiologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tokodai, Kazuaki</au><au>Lannsjö, Claudia</au><au>Kjaernet, Felicia</au><au>Romano, Antonio</au><au>Januszkiewicz, Anna</au><au>Ericzon, Bo‐Göran</au><au>Nowak, Greg</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of post‐reperfusion syndrome and ischemia‐reperfusion injury with acute kidney injury after liver transplantation</atitle><jtitle>Acta anaesthesiologica Scandinavica</jtitle><addtitle>Acta Anaesthesiol Scand</addtitle><date>2020-07</date><risdate>2020</risdate><volume>64</volume><issue>6</issue><spage>742</spage><epage>750</epage><pages>742-750</pages><issn>0001-5172</issn><issn>1399-6576</issn><eissn>1399-6576</eissn><abstract>Background
Acute kidney injury (AKI) is frequently observed after orthotopic liver transplantation (OLT) even in patients with previously normal renal function. In this study, we investigated the impact of factors such graft steatosis, post‐reperfusion syndrome (PRS), and hepatic ischemia reperfusion injury (HIRI) on the development of AKI after OLT in adult patients.
Methods
We retrospectively examined consecutive adult patients who underwent OLT at our institution between July 2011 and June 2017. AKI was diagnosed based on the criteria proposed by the International Kidney Disease Improving Global Outcomes (KDIGO) workgroup. Peak aspartate aminotransferase (AST) level within 72 hours after OLT was used as a surrogate marker for HIRI. Graft steatosis was diagnosed by histopathological examination using specimens biopsied intraoperatively at the end of transplantation procedure and categorized as <10%, 10%‐20%, 20%‐30%, and ≥30% of hepatic steatosis.
Results
Out of 386 patients, 141 (37%) developed AKI (KDIGO stage 1:71 patients; stage 2:29 patients; stage 3:41 patients). Multivariable logistic regression analysis revealed that cold ischemic time (P = .012) and HIRI (P = .007) were independent risk factors for post‐OLT AKI. Multivariable analysis also revealed that graft steatosis was associated with HIRI but not directly with AKI. PRS was not associated with HIRI or AKI in the multivariable analyses.
Conclusion
Our results indicate that greater severity of liver graft injury during transplantation negatively affects renal function after OLT. As expected, the severity of liver graft steatosis contributes to accelerated liver injury occurring during the transplantation procedure.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32020588</pmid><doi>10.1111/aas.13556</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0607-8250</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Acta anaesthesiologica Scandinavica, 2020-07, Vol.64 (6), p.742-750 |
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| source | Wiley |
| subjects | Aspartate aminotransferase Fatty liver Grafting Injuries Ischemia Kidney diseases Kidney transplantation Kidneys Liver Liver transplantation Medicin och hälsovetenskap Regression analysis Renal function Reperfusion Risk analysis Risk factors Steatosis Transplantation |
| title | Association of post‐reperfusion syndrome and ischemia‐reperfusion injury with acute kidney injury after liver transplantation |
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