Intrarenal resistance index for the assessment of acute renal injury in a rat liver transplantation model

Hai-Ying Kong,Li-Qing Wang,Fen Chen,Sheng-Mei Zhu,Yong He,Shu-Sen Zheng,Lin-Jiao Wu

doi:10.1186/1471-2369-14-55

Hai-Ying Kong, Li-Qing Wang + Show 5 more

Open Access

https://doi.org/10.1186/1471-2369-14-55

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Abstract

BackgroundAcute kidney injury (AKI) is a common complication after liver transplantation (LT) and associated with a high mortality. The renal resistive index (RI) is used to assess early renal function impairment in critical care patients. However, limited data are available concerning changes of renal RI and the development of AKI early after reperfusion. We approached to investigate the changes of renal RI and AKI after reperfusion in a rat liver transplantation model.MethodsRats were randomly divided into sham group or LT group. Ten rats in each group were used for the hemodynamic study and twenty for Doppler measurements during the procedure. Ten rats were sacrificed 30 min or 2 h after the reperfusion. We harvested kidneys, serum and urine for further analysis of the renal function.ResultsThe intrarenal RI increased significantly in the anhepatic stage and decreased significantly after the reperfusion in the LT group compared with sham group (P < 0.05). AKI was seen after the reperfusion in the LT group. No correlation was noted between the RI and renal function parameters 30 min after reperfusion.ConclusionsThe intrarenal RI increased significantly during the anhepatic stage, and decreased significantly early after the reperfusion. Intrarenal RI was unable to assess renal function in a rat liver transplantation model.

Highlights

Acute kidney injury (AKI) is a common complication after liver transplantation (LT) and associated with a high mortality
Hemodynamic changed during liver transplantation In the LT group, mean arterial pressure (MAP) decreased slightly while HR increased significantly during the anhepatic stage
After a compensatory increase of MAP and decrease of HR during the initial reperfusion stage, the MAP, HR changed gradually toward the value recorded at baseline after the reperfusion in the LT recipients (Table 1)

Summary

Introduction

Acute kidney injury (AKI) is a common complication after liver transplantation (LT) and associated with a high mortality. The precise cause of the renal injury after LT remains elusive and is likely multifactor [2,5,7,8,9], renal vascular tone is one of the factors closely related to the effective renal perfusion and subsequent renal function [10,11,12]. In many cases, such as hemorrhagic shock, immediate elevations in renal RI have been reported and renal injury may occur as a functional disorder secondary to splanchnic pooling of blood, reduced effective arterial volume and compensatory activation of vasopressor systems leading to increased renal vascular tone [13].

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