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Acute Kidney Injury after Liver Transplantation Cover

Figures & Tables

Stages of AKI according to KDIGO 2012

StagesCr (μ mol/l)Diuresis

11.5 – 1.9 times the baseline value or increase by 26.5 μ mol/l in 48 hours<0.5ml/kg/hour for 6 – 12 hours
2

32.0 – 2.9 times the baseline value<0.5ml/kg/hour for ≥ 12 hours

3.0 times the baseline value or increase by ≥ 353.6 μ mol/l or initiation of renal function replacement< 0.3ml/kg/hour for ≥ 24 hours or anuria

Diagnostic criteria of HRS-AKI according to ICA

Cirrhosis, acute liver failure, acute liver failure in the field of its chronic disease
26.5 μ mol/l increase in sCr over 48 hours or ≥ 50% increase from baseline and/or diuresis < 0.5 ml/kg/hr for ≥ 6 hours
Absence of a decrease in sCr after 2-day discontinuation of diuretics and albumin volume expansion, the recommended dose of albumin is 1 g/kg body weight, maximum 100g
Absence of shock
Exclusion of recent administration of nephrotoxic drugs
Exclusion of parenchymal kidney damage Absence of proteinuria 500 mg/day, microhaematuria 50 erythrocytes in the field of view, normal sonographic findings
Suspected renal vasoconstriction at FENa < 0.2% (values < 0.1% indicate high risk)

Stages of CKD according to KDIGO

Albuminuria (mg/g)
GFR categorieseGFR (ml/min/1.73 m2)A1A2A3
<3030–299≥300
G1≥ 90
G260 – 89
G3a45 – 59
G3b30 – 44
G415 – 29
G5< 15

AKI risk factors after liver transplantation

Pre-transplantPerioperativePost-transplant
AKIHypotensionCNI
CKDPostreperfusion syndromeNephrotoxic drugs
ObesityBlood lossDiuretics
HypertensionNumber of transfusionsInfections
DiabetesOliguria
Hepatitis B, C
HCC
Alcoholic liver disease
Donor age > 60 years
BMI ≥ 30 years
Cold ischemia time
Warm ischemia time
Marginal donor
Infections
DOI: https://doi.org/10.2478/acm-2024-0009 | Journal eISSN: 1338-4139 | Journal ISSN: 1335-8421
Language: English
Page range: 66 - 74
Submitted on: Feb 27, 2024
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Accepted on: Jun 17, 2024
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Published on: Aug 31, 2024
Published by: Sciendo
In partnership with: Paradigm Publishing Services
Publication frequency: 3 issues per year

© 2024 Konkolova Martina, Skladany Lubomir, Cellar Marcel, Kleinova Patricia, Blichova Timea, Beliancinova Monika, Granak Karol, Dedinska Ivana, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.