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Impact of Renal Dysfunction on Liver Transplantation: a Retrospective Study in 708 Orthotopic Liver Transplant Recipients

dc.contributor.authorFerreira, AC
dc.contributor.authorNolasco, F
dc.contributor.authorSampaio, S
dc.contributor.authorBaptista, A
dc.contributor.authorPessegueiro, P
dc.contributor.authorMonteiro, E
dc.contributor.authorBarroso, E
dc.date.accessioned2013-02-06T13:46:01Z
dc.date.available2013-02-06T13:46:01Z
dc.date.issued2010
dc.description.abstractRenal dysfunction often complicates the course of orthotopic liver transplant recipients and is associated with increased morbid -mortality. The aims of this study were to determine the incidence of chronic renal disease and its impact on patient survival. Clinical data included age, gender and weight,aetiology of hepatic failure, presence of diabetes,hypertension, hepatitis B and C infection, renal dysfunction pretransplant and immunosuppression. Laboratory data included serum creatinine at days 1, 7, 21, month 6, 12 and yearly. The glomerular filtration rate was determined by Cockcroft-Gault equation. We studied retrospectively from September 1992 to March 2007 708 orthotopic liver transplant recipients. Mean age 44±12.6 years, 64% males, 17% diabetic, 18.8% hypertensive, 19.9% with hepatitis C and 3.8% hepatitis B. Renal dysfunction pretransplant was known in 21.6%. Mean follow-up was 3.6 years. Mean transplant survival 75% at 12 months. 154 patients died. Univariate and multivariate analyses were performed and a p<0.05 was considered significant. Acute kidney injury occurred in 33.2%. Chronic kidney disease stage 3 was observed in 34.3%,stage 4 in 6.2% and stage 5 in 5.1%. At the time of this study, 46.4% were on Cyclosporine A, 44.7% on tacrolimus and 8.9% on sirolimus. Using multivariate analysis, renal dysfunction was correlated with renal dysfunction pre -orthotopic liver transplant (p<0.001), acute kidney injury (p<0.001), haemodialysis development (p<0.001), and inversely correlated with the use of mycophenolate mophetil (p<0.001); mortality was positively correlated with renal dysfunction pretransplant (p=0.03),chronic kidney disease stage 4 (p=0.001), chronic kidney disease stage 5 (p<0.001) and inversely correlated with the use of tacrolimus (p=0.006). In conclusion orthotopic liver transplant recipients are disposed to renal complications that have a negative impact on survival of these patients.por
dc.identifier.citationPort J Nephrol Hypert 2010; 24 (1): 45-50por
dc.identifier.urihttp://hdl.handle.net/10400.17/1018
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherSociedade Portuguesa de Nefrologia e Hipertensãopor
dc.subjectDoença Crónicapor
dc.subjectEstudos Retrospectivospor
dc.subjectTransplantação de Fígadopor
dc.subjectMortalidadepor
dc.titleImpact of Renal Dysfunction on Liver Transplantation: a Retrospective Study in 708 Orthotopic Liver Transplant Recipientspor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage50por
oaire.citation.startPage45por
oaire.citation.titleRevista Portuguesa de Nefrologia e Hipertensãopor
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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