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


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.


CONCLUSIONS
Perioperative and especially intraoperative use of CRRT therapy can potentially improve the outcomes of patients undergoing OLT.
Department of Anesthesiology, Pennsylvania State University College of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA.
L
L
Douthitt
D
D
Bezinover
T
T
Uemura
Z
Z
Kadry
R A
RA
Shah
N
N
Ghahramani
P K
PK
Janicki
D058186:Acute Kidney Injury / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D058625:End Stage Liver Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D019990:Perioperative Care; D020127:Recovery of Function; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult