The AKI Prediction Score: a new prediction model for acute kidney injury after liver transplantation
2019; Elsevier BV; Volume: 21; Issue: 12 Linguagem: Inglês
10.1016/j.hpb.2019.04.008
ISSN1477-2574
AutoresMarit Kalisvaart, Andrea Schlegel, I. Umbro, Jubi E. de Haan, Wojciech G. Polak, Jan N.M. IJzermans, Darius F. Mirza, M. Thamara P. R. Perera, John Isaac, James Ferguson, Anna Paola Mitterhofer, Jeroen de Jonge, Paolo Muiesan,
Tópico(s)Renal Transplantation Outcomes and Treatments
ResumoAcute kidney injury (AKI) is a frequent complication after liver transplantation. Although numerous risk factors for AKI have been identified, their cumulative impact remains unclear. Our aim was therefore to design a new model to predict post-transplant AKI.Risk analysis was performed in patients undergoing liver transplantation in two centres (n = 1230). A model to predict severe AKI was calculated, based on weight of donor and recipient risk factors in a multivariable regression analysis according to the Framingham risk-scheme.Overall, 34% developed severe AKI, including 18% requiring postoperative renal replacement therapy (RRT). Five factors were identified as strongest predictors: donor and recipient BMI, DCD grafts, FFP requirements, and recipient warm ischemia time, leading to a range of 0-25 score points with an AUC of 0.70. Three risk classes were identified: low, intermediate and high-risk. Severe AKI was less frequently observed if recipients with an intermediate or high-risk were treated with a renal-sparing immunosuppression regimen (29 vs. 45%; p = 0.007).The AKI Prediction Score is a new instrument to identify recipients at risk for severe post-transplant AKI. This score is readily available at end of the transplant procedure, as a tool to timely decide on the use of kidney-sparing immunosuppression and early RRT.
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