IMPACT OF PRETRANSPLANT RENAL FUNCTION ON SURVIVAL AFTER LIVER TRANSPLANTATION

作者：Thomas A. Gonwa, Göran Bo Gustaf Klintmalm, Marlon F. Levy, LINDA S. JENNINGS, Robert Michael Goldstein, Bo S. Husberg · 发表于：Transplantation · 年份：1995 · DOI：10.1097/00007890-199502150-00010 · 被引用次数：442 · 研究领域：Organ Transplantation Techniques and Outcomes、Renal Transplantation Outcomes and Treatments、Liver Disease and Transplantation

To determine the effect of pretransplant liver function on survival following orthotopic liver transplantation and to quantify the effects of cyclosporine administration on long-term renal function in patients undergoing liver transplant, we performed an analysis of a prospectively maintained database. Data from 569 consecutive patients undergoing liver transplantation alone who were treated with CsA for immunosuppression were used for this study. Actuarial graft and patient survival rates were calculated using Kaplan-Meier statistics. Glomerular filtration rates, serum creatinine, and the use of various immunosuppressives were analyzed for this study. The initial analysis demonstrated that patients presenting for liver transplant with hepatorenal syndrome have a significantly decreased acturial patient survival after liver transplant at 5 years compared with patients without hepatorenal syndrome (60% vs. 68%, P < 0.03). Patients with hepatorenal syndrome recovered their renal function after liver transplant. Patients who had hepatorenal syndrome were sicker and required longer stays in the intensive care unit, longer hospitalizations, and more dialysis treatments after transplantation compared with patients who did not have hepatorenal syndrome. The incidence of end-stage renal disease after liver transplantation in patients who had hepatorenal syndrome was 7%, compared with 2% in patients who did not have hepatorenal syndrome. To more fully examine the effect of pretranspla...