Renal dysfunction (RD) is frequent complication following liver transplantation; it predispose to further complications that are associated with a high mortality. However, postoperative renal function after split liver transplant (SLT) and partial living related liver transplant (LRLT) has not been well studied. Renal function immediately after surgery was analyzed retrospectively in 32 patiants that received SLT and LRLT. The results were compared to with corresponding data from 42 matched patients that received full size liver transplant (FSLT) during the same period. Serum creatinine (SCr) was measured before surgery, and, after transplantation daily during the first week and at day 14, 21, and 28 thereafter. Renal dysfunction was defined as the requirement for renal replacement therapy (RRT) or a 100% increase in SCr if the basal value had been <1.0 mg/dl or a 50% increase in SCr if the basal value had been >1.0 mg/dl. The incidence of acute rejection, reoperation, and complication such as sepsis was higher in SLT and LRLT group than FSLT group (P<0.05). There were no significant differences between groups with respect to MELD, CTP score, the need for transfusions, the length of admission to the hospital and ICU.RD developed in 25.8% of SLT and LRLT patients, but in only 9.5% of FSLT patients (p=0.063). The requirement for RRT in SLT and LRLT group (12.5%) was greater than that in the FSLT group (2.3%); P=0.20. The prevalence of postoperative renal failure in our patients [(16.2%) (25.8% in split and partial liver transplant SLT patients and 9.5% in full-size liver transplant FSLT] was relatively lower than in other series. In our study despite higher incidence of RD in split and living related liver transplant (25.8% of patients) than full-size liver transplant (9.5% of patients), this difference is not statistically significant (P=0.063). This finding may relate to the criteria that we used to define RD and the limited number of patients studied, particularly in the SLT group. Our findings suggest that there is higher incidence of renal dysfunction in patients who received split and living-related renal graft than in those that receive full-size graft.
Volume : 6
Issue : 4
Pages : 189
Shiraz Transplant Center, Namazi hospital, and Nephrology- Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran