101. Role of serum levels of intraoperative brain natriuretic peptide for predicting acute kidney injury in living donor liver transplantation
- Author
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Sang Hyun Hong, Hyun Sik Chung, Hyung Mook Lee, Ho Joong Choi, Misun Park, Hyunjoon Park, Min Suk Chae, Jong Ho Choi, and Chul Soo Park
- Subjects
Male ,Blood transfusion ,medicine.medical_treatment ,Peptide Hormones ,Blood Pressure ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Gastroenterology ,Biochemistry ,Vascular Medicine ,Brain Natriuretic Peptide ,Liver disease ,Intraoperative Period ,0302 clinical medicine ,Ischemia ,Natriuretic Peptide, Brain ,Natriuretic peptide ,Living Donors ,Medicine and Health Sciences ,Brain Damage ,Multidisciplinary ,Acute kidney injury ,Living-Related Liver Transplantation ,Hematology ,Acute Kidney Injury ,Middle Aged ,Brain natriuretic peptide ,Prognosis ,Clinical Laboratory Sciences ,female genital diseases and pregnancy complications ,Neurology ,Medicine ,030211 gastroenterology & hepatology ,Female ,Anatomy ,Research Article ,medicine.medical_specialty ,medicine.drug_class ,Science ,Surgical and Invasive Medical Procedures ,03 medical and health sciences ,Digestive System Procedures ,Natriuretic Peptide ,Diagnostic Medicine ,Internal medicine ,medicine ,Humans ,Blood Transfusion ,Transplantation ,business.industry ,Transfusion Medicine ,urogenital system ,Biology and Life Sciences ,Kidneys ,Perioperative ,Renal System ,Organ Transplantation ,medicine.disease ,Hormones ,Liver Transplantation ,Packed red blood cells ,business ,Kidney disease - Abstract
Background Patients with end-stage liver disease frequently experience acute kidney injury (AKI) after living donor liver transplantation (LDLT). Serum levels of brain natriuretic peptide (BNP) have increasingly been accepted as a predictor of AKI in clinical settings. This study investigated the predictive role of intraoperative BNP levels in the early development of AKI after LDLT. Patients and methods Adult patients (≥19 years old) who had undergone elective LDLT from January 2011 to December 2017 were classified into the non-AKI and AKI groups according to the Kidney Disease: Improving Global Outcomes criteria. Serum levels of BNP were measured three times in the preanhepatic, anhepatic, and neohepatic phases. Perioperative data in recipients and donors were analyzed retrospectively. Results Sixty-one patients (22.4%) suffered from AKI immediately after LDLT. Severity according to AKI stage was as follows: 28 patients in stage 1 (10.3%), 18 patients in stage 2 (6.6%), and 15 patients in stage 3 (5.5%). In the neohepatic phase, both BNP levels and proportions of patients with high BNP levels (≥100 pg/mL) were higher in the AKI group than in the non-AKI group. Only BNP levels in the non-AKI and AKI stage 1 groups significantly decreased from the preanhepatic phase to the neohepatic phase; those in AKI stages 2 and 3 groups did not. In particular, BNP levels of all AKI stage 3 patients increased to more than 100 pg/mL, and the proportion of patients with high levels also increased significantly through the surgical phases in the AKI stage 3 group. In multivariate analyses, BNP levels in the neohepatic phase were significantly associated with early development of AKI after LDLT, as well as the total amount of packed red blood cells in transfusions and total duration of graft ischemia. Conclusions Monitoring serum levels of BNP is useful for predicting the early development of AKI after LDLT.
- Published
- 2018