[Living donor liver transplantation for a patient with renal failure].
Pretransplant renal failure is a well-known risk factor which adversely affects the prognosis after liver transplantation. We report a case with pretransplant renal failure and discuss the perioperative management of such patient. The patient was 62 year-old-woman who was diagnosed with end-stage liver disease due to primary biliary cirrhosis, for which living donor liver transplantation (LDLT) was indicated. Her pretransplant serum creatinine was 9.4 mg/dl due to combination of drug-induced (antibiotics) acute tubular necrosis and hepatorenal syndrome. The management of renal failure consisted of the avoidance of calcineurin inhibitor as an induction immunosuppression and the use of perioperative continuous hemodiafiltration (CHDF). The postoperative course of the patient was complicated with CMV pneumonia and acute rejection, however she recovered and discharged on 94 POD with well-preserved graft function and normal renal function without any adverse sequela. LDLT for patients with renal failure can be performed successfully by careful management.
Ijichi
Hideki
H
Department of Surgery and Science, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Shimada
Mitsuo
M
Suehiro
Taketoshi
T
Soejima
Yuji
Y
Maehara
Yoshihiko
Y
Nakamuta
Makoto
M
Nawata
Hajime
H
D058186:Acute Kidney Injury / Q000150:complications* / Q000628:therapy; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D019990:Perioperative Care; D016896:Treatment Outcome
D004232:Diuretics; D007166:Immunosuppressive Agents