title: Postoperative troponin T elevation as a predictor of early acute kidney injury after orthotopic liver transplantation: a preliminary retrospective study.
abstract: BACKGROUND
  Slight alterations in cardiac enzymes are frequently observed perioperatively among liver transplant patients. The significance of these changes in the absence of ongoing acute cardiac pathology is unknown. We sought to evaluate the link between early postoperative anomalies of serum cardiac troponin T (cTnT) in the absence of an evident cardiac cause and kidney injury during the first week of hospital stay.
  
  
  METHODS
  We retrospectively enrolled 30 patients in the study, recording several perioperative variables, particularly cTnT on intensive care unit ICU arrival as well as 6 and 12 hours later. We grouped patients with cTnT levels >0.03 ng/mL as the high-TnT group; the others were control subjects. We recorded the highest serum creatinine, aspartate aminotransferase, alanine aminotransferase, and bilirubin levels during the first week of the hospital stay. Glomerular filtration rate (GFR) was calculated according to the Cockroft-Gault formula.
  
  
  RESULTS
  Ten patients composed the high-TnT group. Their perioperative variables showed higher Model for End-Stage Liver Disease (MELD) scores and significantly greater incidences of acute kidney injury, failure, and dialysis need than control patients. GFR dropped from 118 to 66 mL/min among this group versus 112 to 105 mL/min in control subjects (P = .021). Binary logistic regression analysis revealed a higher association between the high-TnT group and acute kidney injury (P = .036) than with the MELD score (P = .719).
  
  
  CONCLUSIONS
  Serum cTnT levels could be influenced by both preoperative and intraoperative conditions that predispose to kidney injury.
authors.affiliation: Department of Anesthesiology, Alma Mater Studiorum University, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Siniscalchi
authors.forename: L
authors.initials: L
authors.lastname: Gamberini
authors.forename: A
authors.initials: A
authors.lastname: Mordenti
authors.forename: E
authors.initials: E
authors.lastname: Bernardi
authors.forename: M
authors.initials: M
authors.lastname: Cimatti
authors.forename: I
authors.initials: I
authors.lastname: Riganello
authors.forename: L
authors.initials: L
authors.lastname: Toccaceli
authors.forename: T
authors.initials: T
authors.lastname: Vecchiatini
authors.forename: M
authors.initials: M
authors.lastname: Diamanti
authors.forename: S
authors.initials: S
authors.lastname: Faenza
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D011184:Postoperative Period; D012189:Retrospective Studies; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T