(1240) Association of Acute Kidney Injury Grade with Primary Graft Dysfunction Grade after Lung Transplantation: A Cohort Study

• Published in: The Journal of heart and lung transplantation Vol. 42; no. 4; p. S529
• Main Authors: Toyoda, T., Thomae, B.L., Kandula, V., Manerikar, A.J., Kaiho, T., Yagi, Y., Cerier, E., Bharat, A., Kurihara, C.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2023.02.1450

Primary graft dysfunction (PGD) and acute kidney injury (AKI) are major early complications of lung transplantation and have been reported to lead to increased mortality. Acidosis, hypoxia and inflammatory conditions, due to lung injury, can contribute to renal dysfunction; however, the association between the severity of PGD and AKI has not been well studied. We analyzed the comorbidity rate between PGD and AKI, and the association between PGD and AKI grade classification. This was a retrospective review of an institutional lung-transplant database. We included consecutive lung transplant recipients treated between January 2018 and June 2022. PGD was defined according to the modified ISHLT criteria. AKI was classified with KDIGO criteria. The Spearman test was used to compare PGD and AKI grades. In total, 206 patients were included in this study. The number of patients with PGD grades 0, 1, 2, and 3 was 119 (57.8%), 25 (12.1%), 34 (16.5%), and 28 (13.6%), respectively. The numbers of patients with AKI grades 0, 1, 2, and 3 were 96 (46.6%), 47 (22.8%), 27 (13.1%), and 36 (17.5%), respectively (Figure 1). Neither PGD nor AKI grade was observed in 69 (33.5%) patients. Both PGD and AKI grades were ≥ 1 in 60 patients (29.1%). A significant correlation was found between PGD and AKI grade (p < 0.001) (Figure 2). AKI grade, as defined by KDIGO, was significantly correlated with the PGD grade. Well-balanced respiratory management and renal protection strategies are essential during the early postoperative period.