[Evaluation of the renal replacement therapy on the liver transplant patients with acute renal failure].
OBJECTIVE
To analyze the preoperative risk factors on liver transplant recipients with acute renal failure(ARF), and to evaluate renal replacement therapy (RRT) as a transitonary therapy before liver transplantation.


METHODS
Liver transplant recipients with acute renal failure treated with renal replacement therapy between January 1st, 2001 and January 1st, 2008 in our center were retrospected. Clinical characteristics, the kinds of RRT and prognosis were analyzed; Logistic regression was applied to analyze the parameters that can forecast the motality of the liver transplant recipients with acute renal failure.


RESULTS
Of the patients who received RRT, 30% survived to liver transplantation, 67.5% died while waiting for liver transplantation. The dead had a higher multiple organ dysfunction score (MODS), and lower mean arterial pressure than those survived to liver transplantation. There was no significant difference in the duration of RRT between continuous renal replacement therapy (CRRT) patients and hemodialysis patients. CRRT patients had a higher MODS, lower mean arterial pressure, lower serum creatinine than hemodialysis patients. Lower mean arterial pressure was statistically associated with higher risk of mortality.


CONCLUSIONS
Though mortality was high, RRT helps part (30%) of patients survive to liver transplantation. Therefore, considering the high mortality without transplantation, RRT is acceptable for liver transplant recipients with ARF.
YUAN
Jin-zhong
JZ
Department of Kidney, Third Xiangya Hospital of Central South University, Changsha 410013, China.
YE
Qi-fa
QF
ZHANG
Hao
H
MING
Ying-zi
YZ
GUI
Ming
M
JI
Ying
Y
Sun
Jian
J
WANG
Jian-wen
JW
REN
Zu-hai
ZH
CHENG
Ke
K
ZHAO
Yu-jun
YJ
SUN
Pei-long
PL
WU
Kun
K
JI
Long-zhen
LZ
D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D000328:Adult; D001794:Blood Pressure; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D006435:Renal Dialysis / Q000379:methods; D017582:Renal Replacement Therapy / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis