Value of MELD-Na score for prediction of the incidence of acute kidney injury early after orthotopic liver transplantation using retrograde perfusion
10.3969/j.issn.1674-7445.2017.05.005
- VernacularTitle:MELD-Na评分对逆行灌注法原位肝移植术后早期急性肾损伤发生的预测作用
- Author:
Guoqing WEI
1
;
Yuan CHENG
;
Qiucheng CAI
;
Fang YANG
;
Yi JIANG
Author Information
1. 福建医科大学福总教学医院肝胆外科
- Keywords:
Liver transplantation;
Retrograde perfusion;
Model for end-stage liver disease (MELD);
Serum Na+;
MELD-Na score;
Postoperative complication;
Acute kidney injury;
Prediction;
Serum creatinine;
Blood urea nitrogen
- From:
Organ Transplantation
2017;8(5):360-364
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of preoperative model for end-stage liver disease combined with serum sodium (MELD-Na) score for the prediction of the incidence of acute kidney injury (AKI) early after liver transplantation. Methods Clinical data of 315 recipients undergoing orthotopic liver transplantation by retrograde inferior vena caval perfusion were retrospectively analyzed. According to preoperative MELD-Na score, all patients were divided into group A (MELD-Na score≤10, n=115), group B (1020, n=82). Preoperative and intraoperative parameters of the recipients were statistically compared among three groups. Preoperative parameters included serum creatinine (Scr), blood urea nitrogen (BUN), albumin (Alb), total bilirubin (TB), prothrombin time-international normalized ratio (PT-INR), mean arterial pressure (MAP) and serum Na+,etc. Intraoperative parameters included operation time, vena caval occlusion time, hemorrhage volume, quantity of red blood cell infusion, quantity of plasma transfusion and total fluid infusion volume, etc. The incidence and staging of AKI early after liver transplantation in the recipients were statistically compared among three groups. Spearman's rank correlation analysis was performed to analyze the correlation between preoperative MELD-Na score and AKI staging. Results Preoperative BUN, Alb, TB, PT-INR, MAP and Na+ in the recipients significantly differed among three groups (all P<0.05). Intraoperative vena caval occlusion time, hemorrhage volume, quantity of red blood cell infusion and quantity of plasma transfusion significantly differed among three groups (all P<0.05). In 315 recipients undergoing liver transplantation, the incidence of AKI within postoperative 1 week was 64.8% (204/315), and 43% (49/115), 71% (84/118) and 87% (71/82) in group A, B and C. Statistical significance was identified among three groups (all P<0.05). Spearman's rank correlation analysis revealed that preoperative MELD-Na score was positively correlated with AKI staging (r=0.442, P=0.000). Conclusions MELD-Na score not only acts as a parameter evaluating preoperative patients' conditions, but also serves as a pivotal parameter predicting postoperative incidence of AKI.
