Abstract
BackgroundThis study investigated the association between the fibrinogen level and the risk of acute kidney injury (AKI) in patients who have undergone living donor liver transplantation (LDLT).Patients and methodsA total of 676 patients who underwent LDLT were analyzed retrospectively. Exclusion criteria included a history of severe kidney dysfunction, emergency operation, deceased donor, ABO-incompatible transplantation, and missing data. The study population was divided into low and normal fibrinogen groups. A 1:1 propensity score (PS) matching analysis was used to evaluate the association between a low fibrinogen level (< 160 mg/dL) and postoperative development of AKI.ResultsIn total, 142 patients (23.1%) developed AKI after LDLT. The PS matching analysis showed that the probability of AKI was two-fold higher in the low fibrinogen group than in the normal fibrinogen group. In addition, patients with AKI had poorer postoperative outcomes such as longer hospitalization, longer ICU stay, and higher mortality than patients without AKI.ConclusionsThe preoperative fibrinogen level may be useful for risk stratification of patients undergoing LDLT in terms postoperative development of AKI.
Highlights
Living donor liver transplantation (LDLT) is a widely performed operation for patients with end-stage liver disease [1]
This study investigated the association between the fibrinogen level and the risk of acute kidney injury (AKI) in patients who have undergone living donor liver transplantation (LDLT)
The propensity score (PS) matching analysis showed that the probability of Acute kidney injury (AKI) was two-fold higher in the low fibrinogen group than in the normal fibrinogen group
Summary
Living donor liver transplantation (LDLT) is a widely performed operation for patients with end-stage liver disease [1]. Fibrinogen and AKI in LDLT reactive protein; DDLT, deceased donor liver transplantation; DM, diabetes mellitus; FFP, fresh frozen plasma; ICU, intensive care unit; IL, interleukin; INR, international normalized ratio; IQR, interquartile; LDLT, living donor liver transplantation; LT, liver transplantation; MELD score, model for end-stage liver disease score; POD, postoperative day; PRBC, packed red blood cells; PRS, postreperfusion syndrome; PS, propensity score; SDP, single donor platelet; sCr, serum creatinine; WBC, white blood cell. Various factors are related to the development of AKI after liver transplantation (LT), including the Model for End-Stage Liver Disease (MELD) score, chronic kidney disease (CKD), diabetes mellitus (DM), body mass index (BMI), and donor age [4,5,6,7].
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