Perioperative Use of Continuous Renal Replacement Therapy for Orthotopic Liver Transplantation

• Published in: Transplantation proceedings Vol. 44; no. 5; pp. 1314 - 1317
• Main Authors: Douthitt, L, Bezinover, D, Uemura, T, Kadry, Z, Shah, R.A, Ghahramani, N, Janicki, P.K
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.06.2012; Elsevier
• Subjects: Acute Kidney Injury - mortality; Acute Kidney Injury - physiopathology; Acute Kidney Injury - therapy; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Emergency and intensive care: renal failure. Dialysis management; End Stage Liver Disease - complications; End Stage Liver Disease - mortality; End Stage Liver Disease - surgery; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Intensive care medicine; Kidney - physiopathology; Liver Transplantation - adverse effects; Liver Transplantation - mortality; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Middle Aged; Pennsylvania; Perioperative Care; Recovery of Function; Renal Replacement Therapy - adverse effects; Renal Replacement Therapy - mortality; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors; Tissue, organ and graft immunology; Treatment Outcome; Young Adult; Pennsylvania; Digestive system; Continuous; Liver; Use; Homotransplantation; Kidney; Medicine; Extrarenal dialysis; Perioperative; Orthotopic transplantation; Treatment; Urinary system; Surgery; Graft; Liver transplantation
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.01.142

Abstract Purpose We present a retrospective study describing the perioperative use of continuous renal replacement therapy (CRRT) for orthotopic liver transplantation (OLT). Materials and Methods We retrospectively reviewed the clinical course of patients who underwent OLT with the perioperative use of CRRT. The following variables were recorded: Gender, age, indication for transplantation, time when CRRT was initiated, postoperative need for CRRT, and the patient and organ (liver, kidneys) outcome up to 1 year after transplantation. Results Among 105 patients who underwent OLT from 2006 to 2010; we used CRRT in 12 cases (11.4%) perioperatively, including 9 (8.3%) patients intraoperatively. Perioperative CRRT was employed for volume, electrolyte, and/or pH management. All patients who underwent CRRT perioperatively were alive at 1 month, 10 (83.3%), at 3 and 6 months and 9 (75%) at 1 year after OLT. Only 1 surviving patient (8.3%) required renal replacement therapy at 1 month after surgery. Renal replacement therapy was not required in any surviving patient up to 12 months posttransplantation. Conclusion Perioperative and especially intraoperative use of CRRT therapy can potentially improve the outcomes of patients undergoing OLT.