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Article Dans Une Revue Transplantation Année : 2021

Prognostic impact of early recovering acute kidney injury following liver transplantation: a multicenter retrospective study.

Mylène Defaye
  • Fonction : Auteur
Anissa Dahmi
  • Fonction : Auteur
Olivier Joannes-Boyau
Faiza Chermak
  • Fonction : Auteur
Laurence Chiche
  • Fonction : Auteur
Christophe Laurent
  • Fonction : Auteur
Mathieu Battelier
  • Fonction : Auteur
Stéphanie Sigaut
  • Fonction : Auteur
Linda Khoy-Ear
  • Fonction : Auteur
Bénédicte Grigoresco
  • Fonction : Auteur
François Cauchy
  • Fonction : Auteur
Claire Francoz
  • Fonction : Auteur
Catherine Paugam Burtz
  • Fonction : Auteur
Sylvie Janny
  • Fonction : Auteur
Emmanuel Weiss
  • Fonction : Auteur

Résumé

Acute Kidney Injury (AKI) is a common complication after liver transplantation (LT) but the specific impact of rapidly resolving AKI is not elucidated. This study investigates the factors associated with early recovery from AKI and its association with post-LT outcomes. Retrospective analysis of 441 liver transplant recipients with end-stage liver disease without pretransplant renal impairment. AKI was defined according to KDIGO criteria and early renal recovery by its disappearance within 7 days post-LT. 146 patients (32%) developed a post-LT AKI, of whom 99 (69%) recovered early and 45 (31%) did not. Factors associated with early recovery were KDIGO stage 1 (OR:14.11; 95%CI:5.59-40.22; P50 % (OR:4.50; 95%CI:1.67-13.46; P=0.003) and AST peak value <1000 U/L (OR:4.07; 95%CI:1.64-10.75; P=0.002) within 48h post-LT. Patients with early recovery had a renal prognosis similar to that of patients without AKI with no difference in estimated glomerular filtration rate between D7 and one year. Their relative risk of developing CKD was 0.88 (95% CI: 0.55-1.41; P=0.6) with survival identical to patients without AKI and better than patients without early recovery (P<0.0001). Most patients with post-LT AKI recover early and have a similar renal prognosis and survival to those without post-LT AKI. Factors associated with early renal recovery are related to the stage of AKI, the extent of liver injury and the early graft function. Patients at risk of not recovering may benefit the most from perioperative protective strategies, particularly those aimed at minimising the adverse effects of CNI.

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Dates et versions

hal-03389929 , version 1 (21-10-2021)

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Citer

Antoine Dewitte, Mylène Defaye, Anissa Dahmi, Alexandre Ouattara, Olivier Joannes-Boyau, et al.. Prognostic impact of early recovering acute kidney injury following liver transplantation: a multicenter retrospective study.. Transplantation, 2021, ⟨10.1097/TP.0000000000003865⟩. ⟨hal-03389929⟩

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