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Outcome of Liver Transplantation in Hepatocellular Carcinoma Patients at Siriraj Hospital.

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Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction
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Renal dysfunction after orthotopic liver transplantation.

Y Sirivatanauksorn1, T Parakonthun1, N Premasathian2

  • 1Hepatopancreatobiliary and Transplant Surgery Unit, Division of General Surgery, Department of Surgery, Siriraj Organ Transplantation Center, Siriraj Hospital, Bangkok, Thailand.

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|April 29, 2014
PubMed
Summary

Acute renal failure (ARF) is common after liver transplants, with hypotension during and after surgery being key risk factors. Identifying these can improve patient outcomes following orthotopic liver transplantation (OLT).

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Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) is a significant complication following orthotopic liver transplantation (OLT).
  • Identifying ARF risk factors is crucial for mitigating its impact on patient outcomes.
  • This study analyzes the incidence and risk factors of ARF post-OLT at Siriraj Hospital.

Purpose of the Study:

  • To determine the incidence of ARF after OLT.
  • To identify independent risk factors associated with ARF development post-OLT.
  • To understand the impact of ARF on patient morbidity and mortality.

Main Methods:

  • Retrospective analysis of OLT patients from January 2002 to December 2009.
  • ARF defined as serum creatinine >1.5x baseline within one week post-operation.
  • Univariate and multivariate analyses were performed to identify risk factors.

Main Results:

  • 81 patients underwent OLT; 71.60% developed ARF.
  • Independent risk factors for ARF included prolonged intraoperative hypotension (>30 min) and postoperative hypotension.
  • The ARF group experienced higher mortality, longer ICU stays, and increased need for blood transfusions and renal replacement therapy.

Conclusions:

  • ARF is a frequent complication after OLT, increasing morbidity and mortality.
  • Prolonged intraoperative and postoperative hypotension are independent predictors of ARF post-OLT.
  • While ARF is common, most patients achieve renal function recovery, though some may require dialysis.