Intraoperative Management of Liver Transplant Patients Without the Routine Use of Renal Replacement Therapy

Transplantation
Dieter AdelmannClaus U Niemann

Abstract

Renal failure is common among patients undergoing liver transplantation. Liver allocation based on the model for end-stage liver disease score has increased the number of recipients who require perioperative renal replacement therapy (RRT). Although RRT can be continued intraoperatively, the risks and benefits of intraoperative RRT are not well defined. The aim of this study is to report the intraoperative management of patients with pretransplant renal failure at a transplant center with extremely infrequent utilization of intraoperative RRT. We performed a retrospective analysis of all adult patients undergoing orthotopic liver or simultaneous liver-kidney (SLK) transplantation between June 2009 and December 2015. Patients were divided into 2 groups based on their need for pretransplant RRT. A total of 785 patients underwent liver or SLK transplant during the study period. One hundred and seventy-four patients (22.2%) required preoperative dialysis. Only 2 patients required intraoperative RRT. There was no difference in the incidence of acidosis or hyperkalemia between patients who required preoperative dialysis and those who did not. We describe the successful management of patients undergoing liver or SLK transplantation al...Continue Reading

References

Dec 26, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Derek R TownsendR T Noel Gibney
Apr 28, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P J ThuluvathS J Pelletier
Dec 1, 2010·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Victor W XiaRandolph H Steadman
Jun 26, 2013·Annals of Transplantation : Quarterly of the Polish Transplantation Society·Joanna Matuszkiewicz-RowińskaJolanta Małyszko
Aug 21, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Takashi MatsusakiTetsuro Sakai
Mar 19, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Mitra K NadimYuri S Genyk
May 24, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·V G AgopianR W Busuttil
Nov 12, 2015·World Journal of Gastroenterology : WJG·Luis Ruiz-del-Árbol, Regina Serradilla

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Citations

Jul 1, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Cary H Paine, Raimund H Pichler
Apr 11, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hui-Bin HuangJun-Ping Qin
May 9, 2019·Seminars in Cardiothoracic and Vascular Anesthesia·Natalie K SmithTetsuro Sakai
Jul 26, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Edward G Clark, Swapnil Hiremath
Mar 17, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Cale A KasselNicholas W Markin

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