title: The relationship between preoperative creatinine clearance and outcomes for patients undergoing liver transplantation: a retrospective observational study.
abstract: BACKGROUND
  Renal failure with following continuous renal replacement therapy is a major clinical problem in liver transplant recipients, with reported incidences of 3% to 20%. Little is known about the significance of postoperative acute renal failure or acute-on-chronic renal failure to postoperative outcome in liver transplant recipients.
  
  
  METHODS
  In this post hoc analysis we compared the mortality rates of 135 consecutive liver transplant recipients over 6 years in our center subject to their renal baseline conditions and postoperative RRT. We classified the patients into 4 groups, according to their preoperative calculated Cockcroft formula and the incidence of postoperative renal replacement therapy. Data then were analyzed in regard to mortality rates and in addition to pre- and peritransplant risk factors.
  
  
  RESULTS
  There was a significant difference in ICU mortality (p=.008), hospital mortality (p=.002) and cumulative survival (p<.0001) between the groups. The highest mortality rate occurred in the group with RRT and normal baseline kidney function (20% ICU mortality, 26.6% hospital mortality and 50% cumulative 1-year mortality, respectively). The hazard ratio in this group was 9.6 (CI 3.2-28.6, p=.0001).
  
  
  CONCLUSIONS
  This study shows that in liver transplant recipient's acute renal failure with postoperative RRT is associated with mortality and the mortality rate is higher than in patients with acute-on-chronic renal failure and postoperative renal replacement therapy.
authors: Surgical Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, Zurich, CH 8091, Switzerland.
authors: Urs
authors: U
authors: Wenger
authors: Thomas A
authors: TA
authors: Neff
authors: Christian E
authors: CE
authors: Oberkofler
authors: Manuel
authors: M
authors: Zimmermann
authors: Paul A
authors: PA
authors: Stehberger
authors: Marcel
authors: M
authors: Scherrer
authors: Reto A
authors: RA
authors: Schuepbach
authors: Silvia R
authors: SR
authors: Cottini
authors: Peter
authors: P
authors: Steiger
authors: Markus
authors: M
authors: Béchir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000706:statistics & numerical data; D051437:Renal Insufficiency / Q000097:blood* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003404:Creatinine