title: Postoperative kidney injury does not decrease survival after liver transplantation.
abstract: OBJECTIVE
  To explore the effect of acute kidney injury (AKI) on long-term survival after conventional orthotopic liver transplantation (OLT) without venovenous bypass (VVB).
  
  
  METHODS
  A retrospective cohort study was carried out on 153 patients with end-stage liver diseases transplanted by the Department of General Surgery and Liver Transplantation of the University of Pernambuco, from August, 1999 to December, 2009. The Kaplan-Meier survival estimates and log-rank test were applied to explore the association between AKI and long-term patient survival, and multivariate analyses were applied to control the effect of other variables.
  
  
  RESULTS
  Over the 12.8-year follow-up, 58.8% patients were alive with a median follow-up of 4.5-year. Patient 1-, 2-, 3- and 5-year survival were 74.5%, 70.6%, 67.9% and 60.1%; respectively. Early postoperative mortality was poorer amongst patients who developed AKI (5.4% vs. 20%, p=0.010), but long-term 5-year survival did not significantly differed between groups (51.4% vs. 65.3%; p=0.077). After multivariate analyses, AKI was not significantly related to long-term survival and only the intraoperative transfusion of red blood cells was significantly related to this outcome (non-adjusted Exp[b]=1.072; p=0.045).
  
  
  CONCLUSIONS
  The occurrence of postoperative acute kidney injury did not independently decrease patient survival after orthotopic liver transplantation without venovenous bypass in this data from northeast Brazil.
authors.affiliation: Division of Abdominal Surgery, Department of Surgery, UPE, Pernambuco, Brazil. olivalneto@globo.com
authors.forename: Olival Cirilo Lucena da
authors.initials: OC
authors.lastname: Fonseca-Neto
authors.forename: Luiz Eduardo Correia
authors.initials: LE
authors.lastname: Miranda
authors.forename: Thales Paulo
authors.initials: TP
authors.lastname: Batista
authors.forename: Bernardo David
authors.initials: BD
authors.lastname: Sabat
authors.forename: Paulo Sérgio Vieira de
authors.initials: PS
authors.lastname: Melo
authors.forename: Américo Gusmão
authors.initials: AG
authors.lastname: Amorim
authors.forename: Cláudio Moura
authors.initials: CM
authors.lastname: Lacerda
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D058625:End Stage Liver Disease / Q000601:surgery; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult