RESUMO
BACKGROUND: Acute renal insufficiency (ARI) usually occurred following liver transplantation due to the surgical trauma and the application of immunosuppressant, which lack of unified diagnostic criteria. OBJECTIVE: To investigate the experience of diagnosis and treatment of ARI following liver transplantation.DESIGN, TIME AND SETTING: The experiment was performed at the 458 Hospital of Chinese PLA from January 2004 to December 2006.PARTICIPANTS: A total of 37 cases received liver transplantation, including 35 males and 2 females, aged 37-67 years, mean aged (48.5±8.9) years. All cases were divided into the liver cancer group (n=16) and liver cirrhosis group (n=21). The liver cirrhosis group included 16 cases with posthepatitic type B cirrhosis, 4 with posthepatitic type C cirrhosis, and 1 with alcoholic cirrhosis. All these cases were in decompensation stage. The final diagnosis was performed by pathological examination. METHODS: The removal of kidney and construction of blood outflow tract was achieved by modified piggy-back liver transplantation. The arterial blood gas analysis, blood routine examination, renal function and liver function were examined more than twice per day. The cephalosporins, Fluconazole and ganciclovir or vancomycin were used for 5-7 days to prevent infections.MAIN OUTCOME MEASURES: The incidence rate of acute ARI, clinical features and outcomes of patients were observed.RESULTS: ARI developed in 19 patients with liver transplantation, 5 patients died, 14 patients recovered in 2-3 weeks. The incidence of ARI following liver transplantation was associated with infection, bleeding shock, respiratory failure and acute respiratory distress syndrome (P < 0.05). CONCLUSION: The incidence of ARI following liver transplantation was 51.35%, with 26.32% mortality rate. The early diagnosis and treatment are the key steps for increasing successful rate of ARI treatment following liver transplantation.
