Acute kidney injury after liver, heart, and lung transplants: dialysis modality, predictors of renal function recovery, and impact on survival.
Recipients of nonrenal organ transplants including the liver, heart, and lung are at risk for developing acute kidney injury (AKI) and chronic kidney disease (CKD). Underlying hepatic or cardiopulmonary failure, prolonged intraoperative hemodynamic instability, and the use of calcineurin inhibitors and nephrotoxic medications have all been suggested to be contributory. The incidence of perioperative AKI has been reported to occur in 17% to 95% in liver transplant recipients, 5% to 30% in heart transplant recipients, and 5% to 60% in recipients of lung transplants. Among those who develop AKI, renal replacement therapy is required in 5% to 35%, 5% to 15%, and 8% to 10% in liver, heart, and lung transplant recipients, respectively. The current article presents an overview of the literature on the choice of dialysis modality and its associated advantages and disadvantages in the management of AKI after liver, heart, and lung transplants. Predictive factors for renal function recovery and the impact of AKI and CKD on survival will also be discussed.
Pham
Phuong-Thu T
PT
Department of Medicine, Nephrology Division, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA. PPham@mednet.ucla.edu
Slavov
Carmen
C
Pham
Phuong-Chi T
PC
D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality*; D016027:Heart Transplantation / Q000009:adverse effects*; D015312:Hemodialysis Solutions; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D016040:Lung Transplantation / Q000009:adverse effects*; D011379:Prognosis; D020127:Recovery of Function; D006435:Renal Dialysis / Q000379:methods*; D015996:Survival Rate
D015312:Hemodialysis Solutions