Perioperative Risk Factors for Early Acute Kidney Injury After Living Donor Liver Transplantation: A Single...

Early acute kidney injury (AKI) is a frequent and severe complication following liver transplantation, significantly influencing both short-term and long-term outcomes of liver transplant recipients. However, data regarding perioperative risk factors for AKI in living donor liver transplantation remain limited.

This retrospective study analyzed 97 adult patients who underwent living donor liver transplantation at Central Military Hospital 108, Hanoi, Vietnam. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria. Clinical and laboratory data were recorded from the electronic medical profile. The risk factors for AKI development were recognized using logistic regression analysis.

Among 97 liver transplant recipients, the incidence of AKI post LT was 63.9% (62/97). Preoperative MELD score (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.01-1.13; P = .019), cold ischemia time (OR, 1.03; 95% CI, 1.00-1.07; P = .050), intraoperative blood loss volume (OR, 1.81; 95% CI, 1.05-3.09; P = .032), and serum lactate within the first 6 hours after transplant (OR, 1.61; 95% CI, 1.21-2.15; P = .001) were identified as independent risk factors for early AKI. Patients with AKI experienced prolonged intensive care unit and hospital stays, higher rates of renal replacement therapy, and increased 1-year post-transplant mortality compared with non-AKI patients.

Preoperative Model for End-Stage Liver Disease score, cold ischemia time, intraoperative blood loss, and early postoperative serum lactate levels are independent risk factors for early AKI. Early AKI is associated with worse clinical outcomes, underscoring the importance of targeted interventions to mitigate the risk of AKI development.