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Perioperative ABO Blood Group Isoagglutinin Titer and the Risk of Acute Kidney Injury after ABO-Incompatible Living Donor Liver Transplantation
- Source :
- Journal of Clinical Medicine, Volume 10, Issue 8, Journal of Clinical Medicine, Vol 10, Iss 1679, p 1679 (2021)
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- For ABO-incompatible liver transplantation (ABO-i LT), therapeutic plasma exchange (TPE) is performed preoperatively to reduce the isoagglutinin titer of anti-ABO blood type antibodies. We evaluated whether perioperative high isoagglutinin titer is associated with postoperative risk of acute kidney injury (AKI). In 130 cases of ABO-i LT, we collected immunoglobulin (Ig) G and Ig M isoagglutinin titers of baseline, pre-LT, and postoperative peak values. These values were compared between the patients with and without postoperative AKI. Multivariable logistic regression analysis was used to evaluate the association between perioperative isoagglutinin titers and postoperative AKI. Clinical and graft-related outcomes were compared between high and low baseline and postoperative peak isoagglutinin groups. The incidence of AKI was 42.3%. Preoperative baseline and postoperative peak isoagglutinin titers of both Ig M and Ig G were significantly higher in the patients with AKI than those without AKI. Multivariable logistic regression analysis showed that preoperative baseline and postoperative peak Ig M isoagglutinin titers were significantly associated with the risk of AKI (baseline: odds ratio 1.06, 95% confidence interval 1.02 to 1.09<br />postoperative peak: odds ratio 1.08, 95% confidence interval 1.04 to 1.13). Cubic spline function curves show a positive relationship between the baseline and postoperative peak isoagglutinin titers and the risk of AKI. Clinical outcomes other than AKI were not significantly different according to the baseline and postoperative peak isoagglutinin titers. Preoperative high initial and postoperative peak Ig M isoagglutinin titers were significantly associated with the development of AKI. As the causal relationship between high isoagglutinin titers and risk of AKI is unclear, the high baseline and postoperative isoagglutinin titers could be used simply as a warning sign for the risk of AKI after liver transplantation.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
lcsh:Medicine
living donor
030230 surgery
Liver transplantation
urologic and male genital diseases
Gastroenterology
Article
therapeutic plasma exchange
03 medical and health sciences
0302 clinical medicine
isoagglutinin
Internal medicine
ABO blood group system
medicine
Blood type
liver transplantation
ABO blood-group system
anti-ABO blood type antibody
business.industry
lcsh:R
Acute kidney injury
General Medicine
Odds ratio
Perioperative
medicine.disease
female genital diseases and pregnancy complications
Confidence interval
Titer
acute kidney injury
030211 gastroenterology & hepatology
business
Subjects
Details
- ISSN :
- 20770383
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....a1e79ca43d6c0b951c9fbc27184f92a5