Analysis Of Risk Factors For Early Acute Renal Failure After Liver Transplantation For Donation After Citizen's Death

Research Objectives: Objective to discuss the risk factors of early acute renal failure of donation after citizen's death(DCD)liver transplantation,so as to prevent acute renal failure after liver transplantation.Clinical data and Methods: Data of 51 patients who underwent(Donation After Cardiac Death,DCD)orthotopic liver transplantation at first affiliated hospital of China Medical University from September 2010 to August 2016 was analyzed?Of the 51 cases of orthotopic liver transplantation,the overall incidence rate of ARF was 32%(n=17).The patient's age,gender,donor warm and ischemia time,cold preservation time,heart rate(1 to 2 minutes),central venous pressure,blood urea nitrogen,serum creatinine,serum potassium,hemoglobin,preoperative TBil,direct preoperative DBil,MELD score,intraoperative urine volume,intraoperative blood loss,intraoperative hypotension input,intraoperative RBC infusion unit,intraoperative cryoprecipitate,plasma,prothrombin time(PT),endogenous coagulation time(APTT)and fibrinogen(FIB)blood gas analysis(PH,BE)were were risk factors of ARF after liver transplantation.Incidence rate,risk factors,clinical prognosis and other impact factors of postoperative ARF are discussed by analyzing perioperative multivariate data.Results: In this series of 51 patients with DCD liver transplantation,17 cases(32.08%)of ARF occurred within one month after operation.Once the diagnosis of ARF was established,continuous renal replacement therapy(CRRT)was used imm ediately.Multivariate logistic regression analysis showed that cold ischemia time,Pr e operation serum creatinine,end stage liver disease score model(MELD)intraop erative hypotension,and intraoperative urine volume flow were risk factors of AR F after liver transplantation.Conclusion: There are many reasons for ARF after liver transplantation.Preoperative high creatinine and end-stage liver disease scoring model(MELD)are important risk factors for postoperative ARF.Whether intraoperative blood pressure,intraoperative urine volume was also statistically significant.Preoperative renal damage should be removed as much as possible,and nephrotoxic drugs should be avoided after surgery.If possible,liver and kidney transplantation should be considered.CRRT can improve the systemic state of patients with early ARF complicated by OLT,and correct water,electrolyte,acid-base balance disorders.It has important clinical application value in the treatment of ARF after liver transplantation.