Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation

doi:10.1007/s11684-007-0031-5

Front. Med.

2007, Vol. 1

Issue (2) : 167-172 https://doi.org/10.1007/s11684-007-0031-5

Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation

SHU Ming¹, PENG Chenghong², CHEN Hao², SHEN Boyong², ZHOU Guangwen², SHEN Chuan², LI Hongwei²

1.Department of General Surgery, Ningbo No. 2 Hospital, Ningbo 315010, China; 2.Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China;

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Abstract An independent association between acute renal failure (ARF) and intra-abdominal hypertension (IAH) after liver transplantation has not been established previously. The aim of this retrospective study was to understand the role of IAH as an independent risk factor for ARF in the early postoperative period. This study involved 62 subjects who underwent liver transplantation. Intra-abdominal pressure (IAP) was measured in the first three days after surgery by using the urinary bladder technique. An IAP of at least 20 mmHg per day was defined as IAH. Clinical parameters between group IAH and group NO-IAH were compared in terms of the incidence of ARF, blood creatinine levels, blood urea nitrogen (BUN) levels, urine volume per hour and glomerular filtration gradient (GFG). Hemodynamic variations were recorded in the first three postoperative days between group ARF and group NO-ARF. The perioperative suspected risk factors of ARF were determined for statistical evaluation using correlation coefficients and logistic regression analysis. In group IAH, 45.8% patients developed ARF as against 7.9% in group NO-IAH; GFG was significantly lower at 0 72 h after surgery; and blood creatinine levels, BUN levels, urine volume per hour were significantly different at 24 72 h after surgery compared with group NO-IAH. The patients with ARF were not significantly different from those without ARF in terms of central venous pressure, pulmonary artery pressure and mean arterial pressure (MAP) in the first three postoperative days despite a significant increase in heart rate at 24 72h after operation. Postoperative IAH, intraoperative MAP and intraoperative blood transfusion volume of more than 15 U were found to be independent risk factors for ARF. IAH impaired renal function and was an independent risk factor for ARF after liver transplantation. Routine measurement should be taken to monitor IAP every eight hours postoperatively.

Issue Date: 05 June 2007

Cite this article:

SHU Ming,PENG Chenghong,LI Hongwei, et al. Intra-abdominal hypertension is an independent cause of acute renal failure after orthotopic liver transplantation[J]. Front. Med., 2007, 1(2): 167-172.

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https://academic.hep.com.cn/fmd/EN/10.1007/s11684-007-0031-5
https://academic.hep.com.cn/fmd/EN/Y2007/V1/I2/167

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