2019-12-01
The AKI Prediction Score: a new prediction model for acute kidney injury after liver transplantation
Publication
Publication
HPB , Volume 21 - Issue 12 p. 1707- 1717
Background: Acute 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. Methods: 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. Results: 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). Conclusion: The AKI Prediction Score is a new instrument to identify recipients at risk for severe posttransplant 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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doi.org/10.1016/j.hpb.2019.04.008, hdl.handle.net/1765/123254 | |
HPB | |
Organisation | Department of Surgery |
Kalisvaart, M., Schlegel, A, Umbro, I., de Haan, J., Polak, W., IJzermans, J., … Muiesan, P. (2019). The AKI Prediction Score: a new prediction model for acute kidney injury after liver transplantation. HPB, 21(12), 1707–1717. doi:10.1016/j.hpb.2019.04.008 |