Impact of Abdominal Aortic Calcification on Chronic Kidney Disease After Liver Transplantation: A Retrospective Study |
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| Affiliation: | 1. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;2. Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan;1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan;2. Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan;3. Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan;1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan;2. Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan;1. Division of Transplantation Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan;2. Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan;3. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;4. Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan |
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| Abstract: | BackgroundWith improved graft and patient survival after liver transplantation (LT), the onset of late complications, such as renal dysfunction, has become a problem. In this study, we aimed to investigate abdominal aortic calcification (AAC), a potential indicator of systemic atherosclerosis, and evaluate the relationship between preoperative AAC and postoperative chronic kidney disease (CKD), as the latter might be a long-term complication after LT.MethodsAmong the 184 LTs performed at our center between 2008 and 2021, 110 LTs with normal renal function (estimated glomerular filtration rate [eGFR] 60 mL/min per 1.73 m2) before surgery were included. These were divided into high- (≥100 mm3) and low-AAC groups (<100 mm3) consisting of 51 and 59 patients, respectively. The AAC volume was automatically calculated for calcifications located in the abdominal aorta using the Agatston method.ResultsThe high-AAC group was older, consisted of more men, and had lower preoperative creatinine and eGFR levels. No significant difference in the onset of postoperative CKD was found between the 2 groups. However, the cumulative incidence of postoperative CKD was significantly higher in the high-AAC group compared with the low-AAC group. Multivariate analysis of postoperative CKD using the Cox proportional hazards model showed significant differences in preoperative AAC ≥100 mm3, recipient age ≥50 years, and preoperative eGFR <75 mL/min per 1.73 m2.ConclusionsThe development of postoperative CKD should be monitored in liver transplant recipients despite normal preoperative renal function. Our study suggests that preoperative AAC may influence postoperative renal dysfunction. |
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