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Role of thrombocytopenia in risk stratification for acute kidney injury after living donor liver transplantation

机译：血小板减少症在活体肝移植后急性肾损伤风险分层的作用

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摘要

The aim of our study was to investigate pre and intraoperative clinical factors, including platelet count, which could inform risk stratification of early acute kidney injury (AKI) after living donor liver transplantation (LDLT). Additionally, the impact of severe thrombocytopenia on AKI risk was assessed using a propensity score (PS)-matched analysis. In total, 591 adult patients who underwent LDLT between January 2009 and December 2018 at our hospital were retrospectively analyzed. Early postoperative AKI was determined based on the KDIGO criteria, and 149 patients (25.2%) developed AKI immediately after surgery. In a multivariate analysis, a lower preoperative platelet count was significantly associated with early postoperative AKI, together with diabetes mellitus, lower hourly urine output, and longer graft ischemic time; furthermore, a decrease in platelet count was correlated with AKI severity. After adjusting for the PS, the probability of AKI was significantly (1.9-fold) higher in patients with severe thrombocytopenia than in those without severe thrombocytopenia. Patients with thrombocytopenia showed a higher postoperative incidence of AKI and a higher requirement for dialysis than those without thrombocytopenia. The platelet count can easily be obtained via regular blood analysis of patients scheduled for LDLT and can be used to identify patients at risk for AKI.
机译：我们的研究目的是调查术前和术中的临床因素，包括血小板计数，这可能会告知活体肝移植（LDLT）后早期急性肾损伤（AKI）的风险分层。此外，使用倾向评分（PS）匹配分析评估严重血小板减少症对AKI风险的影响。我们对2009年1月至2018年12月期间在我院接受LDLT治疗的591名成年患者进行了回顾性分析。根据KDIGO标准确定术后早期AKI，149名患者（25.2%）在术后立即发生AKI。在多变量分析中，术前血小板计数较低与术后早期AKI、糖尿病、每小时尿量较低和移植物缺血时间较长显著相关；此外，血小板计数下降与AKI严重程度相关。调整PS后，严重血小板减少症患者发生AKI的概率显著（1.9倍）高于无严重血小板减少症患者。血小板减少症患者术后AKI发生率和透析需求均高于无血小板减少症患者。通过定期对计划进行LDLT的患者进行血液分析，可以很容易地获得血小板计数，并可用于识别有AKI风险的患者。

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  • 来源
    《Platelets》 |2021年第4期|共10页
  • 作者

    Park Jaesik; Jeong Jangsu; Choi Ho Joong; Shim Jung-Woo; Lee Hyung Mook; Hong Sang Hyun; Park Chul Soo; Choi Jong Ho; Chae Min Suk;

  • 作者单位

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Yeouido St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Surg Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

    Catholic Univ Korea Seoul St Marys Hosp Coll Med Anesthesiol &

    Pain Med Seoul South Korea;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 基础医学;
  • 关键词

    Acute kidney injury; living donor liver transplantation; platelets;

    机译：急性肾损伤;活体供体肝移植;血小板;

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