Acute kidney injury following living donor liver transplantation

BACKGROUND: Although acute kidney injury (AKI) is regarded as a frequent complication following deceased donor liver transplantation, the incidence of AKI following living donor partial liver transplantation (LDLT) has not yet been sufficiently investigated. PATIENTS AND METHODS: we used two definitions and investigated the influence of AKI on patient and graft survival. The definitions for the degree of AKI were as follows: AKI 1 was characterized by an increase in serum creatinine of 0.5 mg/dL, while AKI 2 was 1.0 mg/dL above the baseline within one wk during the post-operative course. The incidence and its impact were investigated. RESULTS: The incidence of AKI 1 was 63.1%. The development of AKI 1 was correlated with intra-operative blood loss (p = 0.013), the length of post-operative ICU stay, and hospitalization (p = 0.020 and 0.038). The incidence of AKI 2 was 27.7%, and AKI 2 was correlated with the length of both the post-operative ICU and hospital stays. The development of AKI 2 was significantly correlated with graft survival (p = 0.015). CONCLUSION: Recognizing the peri-operative risk and development of AKI is important, because AKI post-LDLT is associated with a poorer graft survival and a possible worse long-term prognosis.