The Etiological Profile of Renal Impairment after Living Donor Liver Transplantation (A Single Center Study in Cairo)

Abstract

Renal injury has been recognized as an increasingly prevalent complication of liver transplantation (LT) over the last decade. Both acute and chronic renal injuries occur with high frequency in liver transplant recipients and are associated with increased morbidity and mortality. The aim of this work was to study the etiological profile of renal impairment in the setting of living donor liver transplantation (LDLT) in a single center of liver transplantation in Cairo. In the present study, 200 patients who underwent LDLT in the period from the beginning of 2008 till June 2013 at the liver transplantation unit of Ain Shams Specialized Hospital and Egypt Air Hospital were included retrospectively. Also, 53 patients who underwent LDLT starting from June 2013 till May 2014 (53 patients) were included prospectively with postoperative one year follow up. All preoperative, intraoperative and postoperative variables were analyzed and reported. The results in this study showed that HCV related liver disease was the main indication for LDLT accounting for 89.7% of transplanted cases. According to the present study, about 57% of patients had AKI post transplantation. Most of them (80%) had occurred during the 1st six months post transplantation. Also, about 66% of patients developed AKI once and 34% of patients developed AKI more than one time. HCV infection was significantly more frequent among AKI cases. Preoperative Child score and MELD score were non significantly worse among patients who developed AKI in the 1st year post transplantation.While preoperative urea, creatinine and GFR were significantly worse among patients with post-transplant AKI.