| Effect of Preoperative Renal Function on Preioperative Renal Function and Clinical Parameters in Liver Transplanted Patients. |
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In Young Huh, Soon Eun Park, Keon Kang, Young Woo Cho, Chul Ho Shin, Gyu Sam Hwang |
1Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, Ulsan, Korea. k2676k@uuh.ulsan.kr
2Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. |
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| Abstract |
BACKGROUND
Liver transplantation (LT) has become the treatment of choice for advanced liver disease. However, renal dysfunction often complicates the course of liver transplant recipients. The preoperative serum creatinine level have been shown to be an important predictor of a short-term graft and patient survival rates and the need for perioperative dialysis. This study examined the impact of the pretransplant renal function on the anesthetic characteristics and renal function after LT.
METHODS
Patients undergoing LT were divided two groups according to the creatinine (Cr) level at time of LT. The following information was collected for each patient: age, etiology, weight and height, serum Cr, Cr clearance, patient survival, and cause of death. The laboratory data was collected at preoperative day, operation day and postoperative 1, 7, 30 days and 6 months. The hemodynamic profile was collected during LT.
RESULTS
There were 27 patients in the renal dysfunction (RD) group. Ascites, total blood transfusion and fluid administration was significantly higher in the RD group. The hemodynamic parameters were similar in both groups. The BUN and Cr levels were significantly higher in the RD group in the perioperative period. At the preoperative period, the AST, ALT, bilirubin and prothrombin time was significantly higher in the RD group. The postoperative ICU stay and mortality rate was higher in the RD group.
CONCLUSIONS
A pretransplant renal dysfunction is the result of deterioration in the liver function in the preoperative period, and indicates a greater requirement of blood and fluid during surgery. |
| Key Words:
creatinine; liver transplantation; renal dysfunction |
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