Korean Journal of Nephrology 2002;21(1):145-151.

원저 : 간이식 후 발생한 급성 신부전의 임상상과 예후 (Original articles : Clinical Features and Effects on Prognosis of ARF that Occurred after Liver Transplantation)

오윤규(Yoon Kyu Oh),한진석(Jin Suk Han),안규리(Cu Rie Ahn),김연수(Yon Su Kim),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),김강석(Kang Seock Kim),이상구(Sang Goo Lee),김성균(Seong Gyun Kim),서경석(Kyung Suk Suh)

Abstract

Background
: One of the major complications of liver transplantation is acute renal failure(ARF). The outcome in patients who develop postoperative renal failure has been dismal. But there are few reports on ARF after liver transplantation in Korea. The aim of this study was to determine the incidence, clinical characteristics, and prognosis of ARF in patients undergoing liver transplantation. Methods : The records of 35 adult patients who received liver transplantation at the Seoul National University Hospital between october 1992 and June 2001 were reviewed retrospectively. Results : 22 patients were male and 13 were female, with an age range of 15 years to 65 years(median, 49 years). The 35 recipients included 18 with liver cirrhosis, 10 with liver cirrhosis and hepatoma, 3 with hepatoma, 3 with fulminant hepatitis, and 1 with biliary atresia. Death occurred in 10 patients (29%) overall. ARF was developed in 25 cases(71%), and 8 cases(32%) expired. Among the 9 patients with peak serum creatinine level ≥2.0 mg/dL, 7 patients expired. 2 patients required hemodialysis following liver transplantation and all of them expired. ARF was developed within 1day(0-39 days). Of 25 ARF cases, 21 cases of hypotension, 6 acute rejection, 10 spontaneous bacterial peritonitis(SBP), and 8 massive packed RBC transfusion were associated. Renal function at latest follow-up was improved in patients who were suffered with ARF. Conclusion : ARF is a frequent complication of liver transplantation, and the strategy of management and prevention of ARF needs to be developed. (Korean J Nephrol 2002;21(1):145-151)