TY - JOUR
T1 - High mortality in orthotopic liver transplant recipients who require hemodialysis
AU - Zand, Martin S.
AU - Orloff, Mark S.
AU - Abt, Peter
AU - Patel, Siddharth
AU - Tsoulfas, George
AU - Kashyap, Randeep
AU - Jain, Ashok
AU - Safadjou, Saman
AU - Bozorgzadeh, Adel
PY - 2011/3
Y1 - 2011/3
N2 - Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri-transplant dialysis on the long-term mortality of liver transplant recipients. We performed a single-center, retrospective cohort study of 743 adult liver transplants; patients who received first liver transplants were divided into four groups: those who received more than one dialysis treatment (hemodialysis [HD], continuous veno-venous hemodialysis [CVVH]) pre-orthotopic liver transplantation (OLT), post OLT, pre- and post OLT, and those not dialyzed. There was no statistically significant difference in the mean survival time for patients who were not dialyzed or dialyzed only pre-OLT. Mean survival times were markedly reduced in patients dialyzed post OLT or both pre- and post OLT compared with those never dialyzed. Mortality risk in a Cox proportional hazards model correlated with hemodialysis post OLT, intra-operative vasopressin or neosynephrine, donor age >50yr, Cr >1.5mg/dL at transplant, and need for subsequent retransplant. Risk of post-OLT dialysis was correlated with pre-OLT dialysis, intra-operative levophed, pre-OLT diabetes, African American race, pre-OLT Cr >1.5, and male gender. We conclude that renal failure requiring hemodialysis post liver transplant, irrespective of pre-transplant dialysis status, is a profound risk factor for death in liver transplant recipients.
AB - Acute renal failure is a significant risk factor for death in patients with liver failure. The goal of this study was to analyze the impact of peri-transplant dialysis on the long-term mortality of liver transplant recipients. We performed a single-center, retrospective cohort study of 743 adult liver transplants; patients who received first liver transplants were divided into four groups: those who received more than one dialysis treatment (hemodialysis [HD], continuous veno-venous hemodialysis [CVVH]) pre-orthotopic liver transplantation (OLT), post OLT, pre- and post OLT, and those not dialyzed. There was no statistically significant difference in the mean survival time for patients who were not dialyzed or dialyzed only pre-OLT. Mean survival times were markedly reduced in patients dialyzed post OLT or both pre- and post OLT compared with those never dialyzed. Mortality risk in a Cox proportional hazards model correlated with hemodialysis post OLT, intra-operative vasopressin or neosynephrine, donor age >50yr, Cr >1.5mg/dL at transplant, and need for subsequent retransplant. Risk of post-OLT dialysis was correlated with pre-OLT dialysis, intra-operative levophed, pre-OLT diabetes, African American race, pre-OLT Cr >1.5, and male gender. We conclude that renal failure requiring hemodialysis post liver transplant, irrespective of pre-transplant dialysis status, is a profound risk factor for death in liver transplant recipients.
UR - http://www.scopus.com/inward/record.url?scp=79953295358&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953295358&partnerID=8YFLogxK
U2 - 10.1111/j.1399-0012.2010.01238.x
DO - 10.1111/j.1399-0012.2010.01238.x
M3 - Article
C2 - 20331690
AN - SCOPUS:79953295358
SN - 0902-0063
VL - 25
SP - 213
EP - 221
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 2
ER -