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Perioperative use of continuous renal replacement therapy for orthotopic liver transplantation
Authors:Douthitt L  Bezinover D  Uemura T  Kadry Z  Shah R A  Ghahramani N  Janicki P K
Affiliation:a Department of Anesthesiology, Pennsylvania State University College of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
b Department of Transplant Surgery, Pennsylvania State University College of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
c Department of Nephrology, Pennsylvania State University College of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
Abstract:

Purpose

We present a retrospective study describing the perioperative use of continuous renal replacement therapy (CRRT) for orthotopic liver transplantation (OLT).

Materials and Methods

We retrospectively reviewed the clinical course of patients who underwent OLT with the perioperative use of CRRT. The following variables were recorded: Gender, age, indication for transplantation, time when CRRT was initiated, postoperative need for CRRT, and the patient and organ (liver, kidneys) outcome up to 1 year after transplantation.

Results

Among 105 patients who underwent OLT from 2006 to 2010; we used CRRT in 12 cases (11.4%) perioperatively, including 9 (8.3%) patients intraoperatively. Perioperative CRRT was employed for volume, electrolyte, and/or pH management. All patients who underwent CRRT perioperatively were alive at 1 month, 10 (83.3%), at 3 and 6 months and 9 (75%) at 1 year after OLT. Only 1 surviving patient (8.3%) required renal replacement therapy at 1 month after surgery. Renal replacement therapy was not required in any surviving patient up to 12 months posttransplantation.

Conclusion

Perioperative and especially intraoperative use of CRRT therapy can potentially improve the outcomes of patients undergoing OLT.
Keywords:
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