title: Intraoperative terlipressin therapy reduces the incidence of postoperative acute kidney injury after living donor liver transplantation.
abstract: OBJECTIVE
  To evaluate the effect of intraoperative infusion with terlipressin on the incidence of acute kidney injury (AKI) after living donor liver transplantation (LDLT).
  
  
  METHODS
  Retrospective case-controlled study.
  
  
  METHODS
  Government hospital.
  
  
  METHODS
  The medical records of 303 patients who underwent LDLT were reviewed retrospectively.
  
  
  METHODS
  Patients were divided into 2 groups on the basis of intraoperative administration of terlipressin. The primary outcome was AKI, as defined by the Acute Kidney Injury Network criteria. Secondary outcomes included the requirement for postoperative dialysis and in-hospital mortality.
  
  
  RESULTS
  The incidence of AKI was 38% (n = 115); AKI occurred in 24 (24.2%) patients who received terlipressin versus 91 (44.6%) in the control group (p = 0.001). The incidence of postoperative dialysis was 9.2% (n = 28). Postoperative dialysis was needed by 8 patients (8.1%) in the terlipressin group versus 20 patients (9.8%) in the control group (p = 0.62). Multivariate logistic regression analysis indicated that terlipressin protected against AKI (odds ratio [OR], 0.4; 95% confidence interval [CI], 0.2-0.8; p = 0.013) but not the need for dialysis (OR, 0.7; 95% CI, 0.2-2.2; p = 0.53) or the in-hospital mortality (OR, 1.1; 95% CI, 0.5-2.3; p = 0.7). Adjustment, using the propensity score, did not alter the association between the use of terlipressin and AKI reduction (OR, 0.46; 95% CI, 0.22-0.89; p = 0.03).
  
  
  CONCLUSIONS
  These results suggested that intraoperative terlipressin therapy is associated with significant reductions in the risk of AKI in LDLT patients.
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt. Electronic address: Ahmed.Mukhtar@kasralainy.edu.eg.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mukhtar
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
authors.forename: Ihab
authors.initials: I
authors.lastname: Mahmoud
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
authors.forename: Gihan
authors.initials: G
authors.lastname: Obayah
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hasanin
authors.affiliation: Department of Anesthesia and Critical Care, Cairo University, Cairo, Egypt.
authors.forename: Fawzia
authors.initials: F
authors.lastname: Aboul-Fetouh
authors.affiliation: Departments of Hepatology.
authors.forename: Hany
authors.initials: H
authors.lastname: Dabous
authors.affiliation: Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bahaa
authors.affiliation: Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Abdelaal
authors.affiliation: Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fathy
authors.affiliation: Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: El Meteini
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008236:Lypressin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D000077585:Terlipressin; D016896:Treatment Outcome
chemical_list: D008236:Lypressin; D000077585:Terlipressin
keywords: dialysis; living donor liver transplantation; mortality; renal injury; risk factors; terlipressin