Liver Transplant Patients with High Levels of Preoperative Serum Ammonia Are at Increased Risk for Postoperative Acute Kidney Injury: A Retrospective Study

Journal of Clinical Medicine

Hyun-Su Ri¹  ByeongSeon Park²  YoonJi Choi²  YoonSook Lee²  JuYeon Park³  Jung-Min Son⁴  KyuHee Park⁵  JeHo Ryu⁶ 

[1] Department of Anaesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea;Department of Anaesthesiology and Pain Medicine, Ansan Hospital, Korea University, College of Medicine, Ansan 15355, Korea;Department of Anesthesiology and Pain Medicine, Daedong Hospital, Busan 47737, Korea;Department of Biostatistics, Clinical Trial Center, Biomedical Research Institute, Pusan National University Hospital, Pusan 49241, Korea;Department of Pediatrics, Korea University Hospital, Ansan 15355, Korea;Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan 50612, Korea;

关键词: acute kidney injury;    ammonia;    complication;    liver transplantation;   

DOI  :  10.3390/jcm9061629

来源: DOAJ

【 摘 要 】

Acute kidney injury (AKI) is one of the most frequent postoperative complications after liver transplantation (LT). Increased serum ammonia levels due to the liver disease itself may affect postoperative renal function. This study aimed to compare the incidence of postoperative AKI according to preoperative serum ammonia levels in patients after LT. Medical records from 436 patients who underwent LT from January 2010 to February 2020 in a single university hospital were retrospectively reviewed. The patients were then categorized according to changes in plasma creatinine concentrations within 48 h of LT using the Acute Kidney Injury Network criteria. A preoperative serum ammonia level above 45 mg/dL was associated with postoperative AKI (p < 0.0001). Even in patients with a normal preoperative creatinine level, when the ammonia level was greater than 45 μg/dL, the incidence of postoperative AKI was significantly higher (p < 0.0001); the AKI stage was also higher in this group than in the group with preoperative ammonia levels less than or equal to 45 μg/dL (p < 0.0001). Based on the results of our research, an elevation in preoperative serum ammonia levels above 45 μg/dL is related to postoperative AKI after LT.

【 授权许可】

Unknown