ASSOCIATION BETWEEN THE NEED FOR RENAL REPLACEMENT THERAPY AND IN-HOSPITAL MORTALITY AFTER ORTHOTOPIC LIVER TRANSPLANTATION

E-Poster

Abstract Title

First Name *

Lucia

Last Name *

Andrade

Co-author 1

Clinton Shin clinton.shin@fm.usp.br University of Sao Paulo School of Medicine Internal Medicine - Nephrology Sao Paulo

Co-author 2

Marcia Fernanda Arantes Oliveira marcia.arantes@hc.fm.usp.br University of Sao Paulo School of Medicine Internal Medicine - Nephrology Sao Paulo

Co-author 3

Marilia Rodovalho marilia_rodovalho@hotmail.com University of Sao Paulo School of Medicine Internal Medicine - Nephrology Sao Paulo

Co-author 4

Igor Smolentzov igor.smolentzov@hc.fm.usp.br University of Sao Paulo School of Medicine Internal Medicine - Nephrology Sao Paulo

Co-author 5

Jose Mauro Vieira Jr jose.mvieira@hc.fm.usp.br University of Sao Paulo School of Medicine Nephrology Sao Paulo

Co-author 6

Lucas Yuji Umesaki Itto lumesaki@gmail.com University of Sao Paulo School of Medicine Internal Medicine - Nephrology São Paulo

Co-author 7

Victor Seabra victor.seabra2@gmail.com University of Sao Paulo School of Medicine Internal Medicine - Nephrology Sao Paulo

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

The mortality associated with liver transplantation ranges from 2% to 36%. Developing acute kidney injury (AKI) and requiring renal replacement therapy (RRT) are associated with higher mortality among liver transplant recipients.

Methods

We conducted a retrospective cohort study using liver transplantation data related to a 4-year period (January 2018 to August 2022) at a quaternary hospital in the metropolitan area of São Paulo, Brazil. We used logistic regression to evaluate the association between RRT and in-hospital mortality after orthotopic liver transplantation.

Results

A total of 504 participants were enrolled in this study. The mean age was 53 years, 61% were men, and the mean Model for End-stage Liver Disease-sodium score was 16.3. The main etiologies of liver disease were chronic hepatitis C and alcohol-related liver disease, which accounted for 26% and 23% of the cases, respectively. The incidence of AKI was 92%, and 29.8% of the patients required RRT. The in-hospital mortality rate was 18.8%.

In a univariate analysis, the need for RRT was associated with an increased risk of in-hospital death (odds ratio [OR], 5.72; 95% confidence interval [CI]: 3.57–9.28). That association persisted in a multivariate analysis, even after adjustment for other variables (OR, 4.71; 95% CI: 2.75–8.14). Among covariates, pretransplant serum ammonia levels and longer anesthesia times were also associated with in-hospital mortality.

Conclusions

The need for RRT seems to be strongly associated with a higher risk of in-hospital mortality among liver transplant recipients (Supported by FAPESP).

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