Analysis Of Risk Factors For Acute Kidney Injury After DCD Donor Liver Transplantation

Objective: Acute kidney injury is one of the common complications after liver transplantation,and has become the main reason for threatening the survival of patients after surgery.The mechanism of acute kidney injury is complicated,and many factors are related to it before and after surgery.In this study,we collected and counted the occurrence of AKI within 1 week after DCD donor liver transplantation,analyzed the risk factors of AKI after DCD donor liver transplantation,provided theoretical guidance for subsequent clinical work,and reduced AKI after liver transplantation.Occurrence,shorten hospital stay,reduce hospital cost,improve patient prognosis,improve postoperative quality of life.Methods: The clinical data of 176 DCD donor liver and liver transplant patients from January 2012 to November 2018 in the hepatobiliary and pancreatic surgery in Li Huili Hospital of Ningbo Medical Center were collected.A total of 159 enrolled patients that met the research criteria were included.Whether AKI occurred within 1 week,the enrolled patients were divided into AKI group and non-AKI group,including 34 cases in AKI group,25 males and 9 females;125 cases in non-AKI group,103 males and 22 females.Collect clinical data of all patients,compare and analyze patients before and after operation including preoperative albumin,MELD,surgical method,intraoperative blood loss,intraoperative infusion volume,intraoperative norepinephrine usage,intraoperative urine volume,operation time,Differences in clinical data such as infection after surgery.SPSS software was used for statistical analysis of relevant data.Results: Among the 159 patients enrolled,34 patients developed AKI within 1 week after operation,and the incidence of AKI was 21.38%.Univariate analysis showed that:preoperative MELD score,preoperative ALB,operation time,intraoperative infusion volume,intraoperative blood loss,intraoperative urine volume,intraoperative hypotension,reoperation within 1 week after operation is affecting AKI Related factors(all P <0.05).Multivariate analysis results showed that: preoperative MELD score,preoperative ALB,intraoperative urine volume,and operation time were independent risk factors for AKI(all P<0.05).Conclusion: The preoperative MELD score,preoperative ALB,intraoperative infusion volume,intraoperative blood loss,intraoperative urine volume,operation time,and whether there was hypotension during the operation.Reoperation within 1 week after surgery was related to the occurrence of AKI after transplantation.Pre-MELD score,preoperative ALB,intraoperative urine output,and operation time are independent risk factors that affect the occurrence of AKI.