Analysis of Risk Factors Related to Acute Kidney Injury After Liver Transplantation in Children

Objective: To identify risk factors related to the development of acute kidney injury (AKI) in children who underwent liver transplantation. Methods: : We retrospectively analyzed data of pediatric patients who underwent liver transplantation at the pediatric surgery department of the First Affiliated Hospital of Guangxi Medical University from July 2017 to November 2018. Subjects were grouped into the non-AKI group (group A) and AKI group (group B). General information, preoperative, intraoperative, and postoperative clinical data were statistically analyzed in the two groups. Results: : Among the 31 patients identified, there were 17 cases in group A (six male, 11 female) and 14 cases in group B (seven male and seven female). The baseline data of the patients included age, BMI index; BSA index; PELD score, TBiL count, ALB count, INR index, Scr count, DBiL, and other liver function indexes. There was no difference observed in the demographic and preoperative factors, including infection rates ( P >.05) between the two groups. There was no difference between the two groups in terms of intraoperative indicators including vena cava occlusion time, cold ischemia time, warm ischemia time, blood loss, donor liver graft-to-recipient body weight, graft volume/standard liver volume, or use of vasopressor drugs ( P >.05). There was no significant difference in postoperative factors (FK506 blood concentration, ICU length of stay, and length of hospital stay) ( P >.05). operation of group A (653±205 min) was significantly shorter than that of group B (852±299 min) ( P =0.03). The duration of anhepatic phase was shorter in group A (57 ± 15 min) than in group B (73 ± 20 min) ( P = 0.02). Conclusion: The incidence of AKI in children after liver transplantation was 45.2%. The operation time and duration of the anhepatic phase were closely related to the occurrence of AKI after liver transplantation in children. Improving the surgical technique and the optimization of surgical procedures can shorten the operation time and the anhepatic phase, therefore reducing the incidence of AKI.